BEHAVIORAL HEALTH BILLING CODING SPECIALIST

Preferred Behavioral Health Group; Toms River (NJ); On-site; USD 60,000 - 70,000; Full time

Benefits offered by this job

Medical, Dental and Prescription Ins.

403(b) Retirement Plan

Generous Paid Time Off and Holidays

Long Term Disability Insurance

Life and AD&D Insurance

Employee Assistance Program

Health Savings Account / Flexible FSA

Voluntary Benefits such as Vision, Pet

Staff Training and Development

Employee Referral Bonus

Job summary

Preferred Behavioral Health Group in New Jersey is seeking an experienced Behavioral Health Medical Billing Coding Specialist to manage claims across NJMHAPP, commercial, Medicare, Medicaid, and state payors.

The ideal candidate has at least 3 years of behavioral health billing/coding experience and is proficient with CPT, ICD-10, HCPCS, and various billing software, with the ability to navigate complex billing environments.

Qualifications

• 3+ years of behavioral health medical billing coding experience.
• Experience in both for-profit and non-profit behavioral health settings preferred.
• Proficiency with commercial, Medicare, Medicaid, state, and county payor portals.

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 inquiries including payment options, hardships, and fees.
• Collaborate with Quality and Compliance to support system configuration and workflow efficiency.
• Coordinate offshore billing team to maintain quality standards and performance goals.

Skills

Billing/coding

Payer portals

Trauma-informed approach

Education

High school diploma or equivalent

Billing Coding Certificates (CPB, CMRS, or equivalent)

Tools

Billing software

Clearinghouse

Inovalon

Job description

If you are looking to make an impact by helping others, then Preferred Behavioral Health Group is the place for you! By joining our award-winning team, you will become part of the premier behavioral health organization in New Jersey. PBHG is a dynamic and innovative non-profit organization that was proudly named one of "THE BEST PLACES TO WORK IN NEW JERSEY" for BOTH 2024 and 2025 by NJBIZ! Our mission is to change lives and save lives across the state of New Jersey through a Trauma Informed Care culture. Our staff is at the core of everything we do. We are dedicated to building a diverse team where employees feel a sense of belonging and are valued for their individual contributions. We encourage staff development and embrace a growth mindset. If you are interested in pursuing an exciting and rewarding career while being part of a recognized “Best Place to Work”, please submit your resume today for consideration!

Job Title: Behavioral Health Medical Billing Coding Specialist

Program: Billing Department

location: Office 52 Hyers Street, Toms River New Jersey

Position Type: Full Time

Salary: $60,000.00 - $70,000.00

Job Description/Summary

We are seeking an experienced, detail-oriented Behavioral Health Medical Billing Coding Specialist with at least 3 years of behavioral health billing coding 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.

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.

Competencies

• Minimum of 3 years of behavioral health medical billing coding experience.
• Experience in both for-profit and non-profit behavioral health settings is preferred.
• Proficiency with commercial, Medicare, Medicaid, state, and county payor portals.

Qualifications

• High school diploma or equivalent required.
• Billing Coding Certificates (CPB, CMRS, or equivalent) are preferred.

Knowledge & Technical Skills

• 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.
• Use a trauma informed approach to all client financial concerns.
• Familiarity with claim submission processes, billing software, EHR/EMR systems.
• Strong problem-solving skills for resolving complex billing and reimbursement issues.

Comprehensive Benefits Package

• Medical, Dental and Prescription Insurance
• 403(b) Retirement Plan
• Generous Paid Time Off and Paid Holidays
• Long Term Disability Insurance
• Life and AD&D Insurance
• Employee Assistance Program
• Flexible Spending Account and Health Savings Account
• Voluntary Benefits, such as Vision Insurance, Aflac, Pet Insurance
• Staff Training and Development Opportunities
• Employee Referral Bonus program

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