BILLING SPECIALIST

PREFERRED BEHAVIORAL HEALTH OF NEW JERSEY; Toms River (NJ); On-site; USD 54,000 - 66,000; Full time

Benefits offered by this job

Medical, Dental and Prescription Insurance

403(b) Retirement Plan

Generous Paid Time Off and Paid Holidays

Employee Assistance Program

Job summary

A leading behavioral health organization in Toms River is looking for a detail-oriented Billing Specialist. This position requires at least 3 years of behavioral health billing experience and proficiency in handling claims with various payors. The ideal candidate will ensure compliance with billing regulations and possess problem-solving skills for complex issues. The role offers a comprehensive benefits package including medical, dental, and retirement plan options. Join our award-winning team dedicated to changing lives across New Jersey.

Qualifications

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

Responsibilities

• Submit claims to various payors following specific rules.
• Conduct timely follow-up on outstanding claims and resolve denials.
• Review payer rejections and compliance with guidelines.

Skills

Behavioral health billing experience

Proficiency with billing software

Understanding of billing regulations

Education

High school diploma or equivalent

Billing certificates (CPB, CMRS, or equivalent)

Tools

Medical office systems

Inovalon experience

Job description

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.

Job Title: Billing Specialist

Program: Finance

Location: 52 Hyers Street, Toms River, New Jersey 08753

Position Type: Full Time

Starting Salary: $60,000.00

Job Description/Summary

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 complex billing environments.

Key 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 the 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, client hardships, and 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 inquiries and client phone calls.

Qualifications

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

Education

High school diploma or equivalent required. Billing 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.
• 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.

Problem-Solving Skills

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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