SENIOR BILLING SPECIALIST

PREFERRED BEHAVIORAL HEALTH OF NEW JERSEY•Toms River, NJ

7d•$65,000•Onsite

About The Position

Ensures timely and accurate billing, payment posting, and account reconciliation across multiple payer systems. The position is essential to capturing revenue, resolving billing issues, and maintaining compliance in a fast-paced behavioral health environment. The position requires a high level of accuracy, initiative, and resilience, particularly in handling self-pay accounts, manual billing and posting, and external client invoicing. Requires to be detail-oriented, proactive, and able to work independently with minimal supervision. Adherence to laws and best practices in regard to dealing with consumers and data.

Requirements

Education - High School Diploma or higher level of education; excellent knowledge of MS Office, Excel, and ER software.
Proficiency with numbers and processing of financial information.
Proven experience as a billing specialist.

Responsibilities

Prepare and submit clean claims to various insurance companies either electronically or by paper
Prepare, review, and send patient statements
Answer questions from consumers, clinical/prescribers, clerical staff and insurance companies
Identifies and resolves consumers billing complaints
Assume the responsibility of receiving and sorting incoming payments with attention to credibility
Evaluate consumer’s financial status and establishes budget payment plans. Follows and reports status of delinquent accounts.
Reviews account for possible assignment and makes recommendations to the Billing Manager or RCM Manager.
Performs various collection actions including contacting consumers by phone, correcting and resubmitting claims to third party payers.
Perform manual billing for services not supported by electronic systems, ensuring accuracy and completeness.
Perform manual payment posting for non-electronic transactions.
Prepare and issue invoices to external clients based on contractual terms and service delivery
Respond to client inquiries regarding invoices, payments, and billing discrepancies.
Write thorough reports on billing activity with clear and reliable data.
Maintains strictest confidentiality, adheres to all HIPAA guidelines/regulations.
Work closely with the Accounting team to design, evaluate, and implement billing processes and system improvements.
Adhere to New Jersey Medicaid billing guidelines for behavioral health services, including service authorization and documentation requirements (MCOs).
Maintain billing practices in accordance with NJ-specific CPT/HCPCS coding standards and reimbursement policies.
Monitor updates from NJ Medicaid and commercial payers regarding behavioral health billing rules and rate changes.
Support compliance with NJ Charity Care and sliding fee scale programs for eligible self-pay patients.
Enter self-pay statement payments and Cognito payments into the billing system.
Monitor and follow up on outstanding self-pay balances to reduce aging and improve collections.
Performs monthly reporting on billing and collection status, and provide analysis as needed.
Ensure posting of payments into computerized billing system and coordinates accurate interface of posted payments with general ledger system
Analyzes patient receivable reports and ensures prompt follow up on unpaid items
Acquires a thorough knowledge of the organization’s programs and billable services as well as a good working relationship with Program & Clinical Specialists
Support audits and compliance checks related to external and internal billing.
Ensure compliance with federal, state (including NJ-specific), and payer-specific billing regulations.
Identify opportunities for process improvements and contribute to billing system enhancements.
Other duties assigned