Medical Billing & Coding Specialist — Behavioral Health

AAPC; Cedar Grove (NJ); Hybrid; USD 32,000 - 55,000; Part time

Job summary

Wellness Direct LLC in Cedar Grove, NJ is seeking a part-time Billing Specialist/Lead to own full-cycle revenue cycle work in TherapyNotes. The role is hybrid with initial on-site ramp-up and ongoing 50% on-site time, reporting to Billing Manager.

Requirements include TherapyNotes experience, CPT/ICD-10 coding proficiency, and knowledge of payer rules. Credentialing is a lead-level responsibility per interview. Compensation is hourly.

Qualifications

• TherapyNotes experience — required.
• Strong working knowledge of CPT and ICD-10 coding.
• Working knowledge of Medicare, Medicare Advantage, Medicaid managed care, and commercial payer rules.
• Demonstrated ability to work denials and appeals independently, without day-to-day direction.

Responsibilities

• Manage the full billing cycle in TherapyNotes: charge entry, claim scrubbing, batch submission, resubmission, and claim holds.
• Process ERAs/EOBs; post payments, adjustments, and denials on a timely cycle; reconcile against deposits.
• Manage insurance AR: aging review, resolution of unpaid and underpaid claims.
• Diagnose denial cause and route or resolve accordingly; file and track appeals.
• Flag recurring denial patterns and recommend process fixes.
• Review CPT/ICD-10 coding, modifiers, place-of-service, and telehealth coding for accuracy.

Skills

TherapyNotes

CPT/ICD-10 coding

Payer rules (Medicare/Medicaid/ commer

Denials & appeals

Tools

TherapyNotes

Job description

About the Role

Wellness Direct LLC is an established behavioral health practice based in Cedar Grove, New Jersey, seeing patients remotely nationwide. This role, however, is hybrid and based out of our Cedar Grove office — see Location & Schedule below for the on-site expectation.

This is one opening, filled at either the Specialist or Lead level depending on the experience the candidate brings; the level is determined during the interview process. The role owns full-cycle revenue cycle work in TherapyNotes: claims, ERA/EOB processing, denials, coding accuracy, patient billing support, and — at the Lead level — credentialing and oversight of the billing function.

Specialist vs. Lead

• Specialist — Owns the day-to-day billing, coding, and claims work. Reports to the Billing Manager. No supervisory responsibility — a fit if you want to stay hands-on rather than manage people.
• Lead — Everything above, plus end-to-end credentialing and payer enrollment, ownership of billing workflows and process documentation, denial-trend root-cause analysis, and department performance reporting to practice leadership.

Responsibilities (both levels)

Claims & payments

• Manage the full billing cycle in TherapyNotes: charge entry, claim scrubbing, batch submission, resubmission, and claim holds.
• Process ERAs/EOBs; post payments, adjustments, and denials on a timely cycle; reconcile against deposits.

AR & denials

• Manage insurance AR: aging review, resolution of unpaid and underpaid claims.
• Diagnose denial cause (coding, eligibility, authorization, enrollment) and route or resolve accordingly; file and track appeals.
• Flag recurring denial patterns and recommend process fixes.

Coding accuracy

• Review CPT/ICD-10 coding, modifiers, place-of-service, and telehealth coding for accuracy and payer-specific rules.
• Trace coding-related denials back to the source and correct with clinicians.

Patient billing & support

• Serve as the billing point of contact for clinicians and clients; respond to patient billing inquiries and explain balances, coverage, and EOBs clearly.
• Manage patient balances and collections; set up and monitor payment plans.
• Maintain HIPAA compliance and PHI confidentiality in all work.

Additional Responsibilities — Lead Only

• Own credentialing end to end: re-credentialing and revalidation calendar, CAQH profiles, payer applications, and payer roster reconciliation.
• Own and document billing workflows and standard operating procedures; coordinate day-to-day billing workflows across the function.
• Own the billing scorecard and report performance, trends, and risks to practice leadership.
• Own payer relationships and escalations; lead root-cause analysis on denial trends.
• Contribute to onboarding and cross-training as the billing function grows.

Requirements

• Located within commuting distance of Cedar Grove, NJ — this role requires regular on-site presence (see Location & Schedule).
• TherapyNotes experience — required.
• Strong working knowledge of CPT and ICD-10 coding.
• Working knowledge of Medicare, Medicare Advantage, Medicaid managed care, and commercial payer rules.
• Demonstrated ability to work denials and appeals independently, without day-to-day direction.
• Experience: Specialist — 3+ years of medical billing and collections experience; credentialing exposure a plus.
• Experience: Lead — 5+ years of medical billing and collections experience, including hands-on credentialing and ownership of a billing function.

Certifications

• Certified Professional Biller (CPB), CMRS, or equivalent — required at the Lead level, strongly preferred at the Specialist level.
• Coding certification (CPC, CCS, or equivalent) — preferred.
• Credentialing certification (CPCS or equivalent) — preferred, mainly relevant at the Lead level.

Preferred

• Behavioral health billing experience specifically, rather than general medical billing.
• Multi-state payer experience, given our remote patient base.
• Medicare enrollment and PECOS experience.

Location & Schedule

• Hybrid, based at our Cedar Grove, NJ office.
• First 60 days: on-site 4-5 days per week for training and ramp-up, approximately 3-4 hours per day.
• After the first 60 days: hybrid, with a minimum of 50% of scheduled hours on-site - typically 2-3 days per week.
• 16 hours per week, scheduled Monday through Friday within core business hours of 9:00 a.m. to 5:00 p.m. Eastern. Specific days and times are set with the Billing Manager.
• Reports to: Billing Manager.

Compensation

• Hourly rate range: $23.00 - $40.00 per hour. Placement within the range reflects level (Specialist or Lead), years of experience, certification, and depth of behavioral health billing and credentialing experience.
• This is a part-time W-2 position. Benefits are not offered for part-time roles at this time.