BILLING SPECIALIST

PREFERRED BEHAVIORAL HEALTH OF NEW JERSEY•Toms River, NJ

2d•Onsite

About The Position

We are seeking an experienced, detail-oriented Billing Specialist with at least 3 years of behavioral health billing experience. The ideal candidate will have experience in both for-profit and non-profit behavioral health organizations and possess expert-level knowledge of NJMHAPP, commercial, Medicare, Medicaid, State, and County behavioral health payors. This role requires accuracy and the ability to navigate in complex billing environments.

Requirements

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

Nice To Haves

Experience in both for-profit and non-profit behavioral health settings is preferred.
Billing Certificates (CPB, CMRS, or equivalent) are preferred.

Responsibilities

Submit claims to NJMHAAP, commercial, Medicare, Medicaid, state, and county payors, following payer-specific rules and regulations.
Conduct timely follow-up on outstanding claims and resolve denials.
Use payer portals for claim submission, eligibility checks, and claims follow-up.
Review payer rejections and reporting in clearinghouse.
Maintain up-to-date knowledge of billing codes, compliance guidelines, and regulatory changes.
Ensure compliance with all federal, state, and local billing regulations.
Review and send patient statements; manage delinquent accounts
Communicate with clients about any billing inquires included but not limited to payment options, client hardships, and client fees.
Collaborate with Quality and Compliance to support optimal system configuration and workflow efficiency.
Coordinate offshore billing team to maintain quality standards and performance goals.
Answer Billing inquires and Client phone calls inquiries.