Remote Medicaid Billing & Eligibility Coordinator

Discovery Institute Drug & Alcohol Rehab New Jersey; Marlboro Township (NJ); Remote; USD 55,000 - 72,000; Full time

Job summary

Discovery Institute Drug & Alcohol Rehab New Jersey is seeking a billing specialist to manage Medicaid and third-party billing, verify insurance, and maintain accurate utilization and reimbursement records. The role supports admissions with eligibility checks and coordinates with counselors regarding authorizations in a remote-capable environment.

The ideal candidate will have strong billing analysis skills, experience with Medicaid processes, and the ability to work independently while

Qualifications

• 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.

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

Authorization processes

Medicaid billing

Billing data analysis

Problem solving

Team collaboration

Tools

KIPU

EMEVS

Job description

Discovery Institute Drug & Alcohol Rehab New Jersey is seeking a billing specialist to manage Medicaid and third-party billing, verify insurance, and maintain accurate utilization and reimbursement records. The role supports admissions with eligibility checks and coordinates with counselors regarding authorizations in a remote-capable environment.

The ideal candidate will have strong billing analysis skills, experience with Medicaid processes, and the ability to work independently while