Billing and Medical Record Analyst

Billing and Medical Record Analyst at Acadia Healthcare

Location: Fully Remote
Hours: Monday through Friday 8:00 AM – 5:00 PM

• Comprehensive Medical, Dental, & Vision insurance
• Competitive 401(k) plan with company match
• Company‑paid group term life insurance and short‑term disability
• Generous PTO:
  Paid vacation, personal time, sick leave, and extended sick leave
• Employee Assistance Program (EAP) offering continued support to employee lifestyle and well‑being
• Career advancement opportunities across a leading national network

Reporting to the Director – Compliance Auditing and Monitoring, the Medical Record Analyst serves as the subject matter expert for medical record reviews as it relates to clinical and financial components of the patient record including medical necessity, quality documentation requirements. The Analyst collaborates with CTC Group Operational Leadership and CTC Business Office to assist with external reviews and/or audits from third‑party payors and governmental agencies.

The Analyst will trend findings from both internal and external reviews/audits to assist with standardizing best practices and training needs of the CTC Group programs.

• Gather, review, and submit all requested and/or required documentation to fulfill medical record requests.
• Track and process medical record requests; post‑payment reviews from third‑party payors and government entities.
• Communicate with third‑party insurance carriers/government agencies to verify medical record content requirements and timelines.
• Coordinate with the clinic and CBO teams to track pre‑payment reviews, identify trends/risks, and report and escalates to leadership.
• Collaborate with CTC Group operational and business office leadership on all payor and governmental agency requests for records.
• Communicate with clinic team and operational leadership when medical record requests are received.
• Assist with review of audit findings and development of audit appeals as needed.
• Communicate findings to leadership and provide recommendations for improvement in processes or EMR functionality based on audit findings.
• Provide monthly and quarterly reports on review trends based on medical record requests and audit findings.
• Maintain effective communication with third‑party insurance carriers to resolve issues identified during the audit process.
• Maintain knowledge of industry standards and trends including CPT, ICD‑10 and Medicare/Medicaid guidelines.
• Provide feedback and recommendations on medical record process improvement.
• Perform other duties as assigned.

Acadia Healthcare’s Comprehensive Treatment Centers (CTC) division operates 170+ CARF‑accredited outpatient opioid treatment programs (OTPs) nationwide, serving patients undergoing treatment for opioid use disorder (OUD). As the leading provider of medication‑assisted treatment (MAT) in the nation, we care for more than 74,000 patients daily. Our mission is to deliver comprehensive care, combining therapies with safe and effective medications. Our team stands at the forefront of the battle against the opioid epidemic.

• Complies with organizational policies, procedures, performance improvement initiatives and maintains organizational and industry policies regarding confidentiality.
• Communicates clearly and effectively to persons receiving services and their family members, guests and other members of the health‑care team.
• Develops constructive and cooperative working relationships with others and maintains them over time.
• Encourages and builds mutual trust, respect and cooperation among team members.
• Maintains regular and predictable attendance.

• Minimum of 4‑5 years’ experience within the outpatient behavioral and substance use disorder (SUD) healthcare is required.
• Previous experience with a proprietary healthcare system is highly preferred.
• Demonstrates strong healthcare billing and coding aptitude and possesses associated technical skills.
• Experience working with IT and proficiency with software packages including Excel.
• Exercises sound judgment in responding to inquiries;…