Billing Coordinator

Discovery; Marlboro Township (NJ); On-site; USD 50,000 - 70,000; Full time

Job summary

Discovery is seeking a Billing Specialist to support outpatient services and ensure accurate Medicaid and Fee-for-Service billing. You will verify insurance, run eligibility checks, and maintain detailed records in KIPU, with weekly reconciliation of billing data and coordination with admissions and counselors.

Responsibilities include preparing claims, tracking authorizations, and addressing funding changes while upholding HIPAA and regulatory compliance.

Qualifications

• Understanding of insurance verification and authorization processes.
• Knowledge of Medicaid billing regulations and reimbursement procedures.
• Ability to analyze billing data and resolve discrepancies.
• Strong problem-solving and critical-thinking skills.
• Ability to work independently and collaboratively within a team.

Responsibilities

• Reconcile bed utilization charts with billing spreadsheets to ensure accuracy and consistency.
• Run eligibility verifications (EMEVS) for potential outpatient admissions and communicate funding information to admissions staff.
• Verify insurance eligibility and update client insurance information within KIPU as needed.
• Conduct monthly eligibility checks for all outpatient clients and update records accordingly.
• Identify and communicate changes in client funding sources.
• Maintain and update outpatient billing spreadsheets on a weekly basis using attendance records.
• Track outpatient authorizations and notify counselors of upcoming authorization expirations.
• Add Vivitrol services to appropriate Fee-for-Service authorizations.
• Prepare and submit outpatient Medicaid and Fee-for-Service claims.
• Reconcile Medicaid and Fee-for-Service payments and correct billing discrepancies.
• Post Medicaid remittance payments to utilization tracking spreadsheets.
• Assist with back-billing of Medicaid claims as needed.
• Process and track state-funded Uber transportation reimbursements.
• Generate and send client deductible and co-payment invoices.
• Provide billing coverage for Detox and Residential Billing Specialists during absences.
• Maintain confidentiality and compliance with all HIPAA, state, federal, and organizational requirements.
• Perform other duties as assigned.

Skills

Insurance verification

Medicaid billing rules

Billing data analysis

Problem solving

Team collaboration

Job description

Responsibilities

• Reconcile bed utilization charts with billing spreadsheets to ensure accuracy and consistency.
• Run eligibility verifications (EMEVS) for potential outpatient admissions and communicate funding information to admissions staff.
• Verify insurance eligibility and update client insurance information within KIPU as needed.
• Conduct monthly eligibility checks for all outpatient clients and update records accordingly.
• Identify and communicate changes in client funding sources.
• Maintain and update outpatient billing spreadsheets on a weekly basis using attendance records.
• Track outpatient authorizations and notify counselors of upcoming authorization expirations.
• Add Vivitrol services to appropriate Fee-for-Service authorizations.
• Prepare and submit outpatient Medicaid and Fee-for-Service claims.
• Reconcile Medicaid and Fee-for-Service payments and correct billing discrepancies.
• Post Medicaid remittance payments to utilization tracking spreadsheets.
• Assist with back-billing of Medicaid claims as needed.
• Process and track state-funded Uber transportation reimbursements.
• Generate and send client deductible and co-payment invoices.
• Provide billing coverage for Detox and Residential Billing Specialists during absences.
• Maintain confidentiality and compliance with all HIPAA, state, federal, and organizational requirements.
• Perform other duties as assigned.

Knowledge, Skills, and Abilities

• Understanding of healthcare insurance verification and authorization processes.
• Knowledge of Medicaid billing regulations and reimbursement procedures.
• Ability to analyze billing data and resolve discrepancies.
• Strong problem-solving and critical-thinking skills.
• Ability to work independently and collaboratively within a team environment.