BEHAVIORAL HEALTH BILLING CODING SPECIALIST

PREFERRED BEHAVIORAL HEALTH OF NEW JERSEY•Toms River, NJ

12h•$60,000 - $70,000•Onsite

About The Position

Preferred Behavioral Health Group is seeking an experienced, detail-oriented Behavioral Health Medical Billing Coding Specialist for its Billing Department. This full-time position is based at the office at 52 Hyers Street, Toms River, New Jersey, and pays $60,000–$70,000. The specialist submits and follows up on claims, resolves denials, supports client billing inquiries, maintains regulatory compliance, and coordinates an offshore billing team. The role calls for at least three years of behavioral health billing and coding experience, familiarity with a range of behavioral health payors and billing systems, and a trauma-informed approach to client financial concerns.

Requirements

At least 3 years of behavioral health medical billing and coding experience.
High school diploma or equivalent.
In-depth understanding of CPT, ICD-10, and HCPCS coding standards.
Proficiency with commercial, Medicare, Medicaid, state, and county payor portals.
Proficiency in medical office systems and billing software.
Strong understanding of payer regulations and behavioral health billing requirements.
Familiarity with claim submission processes, billing software, and EHR/EMR systems.
Strong problem-solving skills for complex billing and reimbursement issues.
Use a trauma-informed approach to client financial concerns.

Nice To Haves

Experience in both for-profit and nonprofit behavioral health settings.
Billing coding certificate such as CPB, CMRS, or equivalent.
Inovalon experience.

Responsibilities

Submit claims to NJMHAPP, commercial, Medicare, Medicaid, state, and county payors in accordance with payer-specific rules and regulations.
Follow up promptly on outstanding claims and resolve denials.
Use payer portals for claim submission, eligibility checks, and claims follow-up.
Review payer rejections and reports in the clearinghouse.
Maintain current knowledge of billing codes, compliance guidelines, and regulatory changes.
Ensure compliance with federal, state, and local billing regulations.
Review and send patient statements and manage delinquent accounts.
Communicate with clients about billing inquiries, including payment options, client hardships, and client fees.
Collaborate with Quality and Compliance to support effective system configuration and workflow efficiency.
Coordinate the offshore billing team to maintain quality standards and performance goals.