BILLING SPECIALIST

Preferred Behavioral Health Group

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: 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 in 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 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 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.
• Answer billing inquiries and client phone calls inquiries.

Qualifications

• Minimum of 3 years of behavioral health billing experience.
• Experience in both for-profit and non-profit behavioral health settings is 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

o Medical, Dental and Prescription Insurance

o 403(b) Retirement Plan

o Generous Paid Time Off and Paid Holidays

o Long Term Disability Insurance

o Life and AD&D Insurance

o Employee Assistance Program

o Flexible Spending Account and Health Savings Account

o Voluntary Benefits, such as Vision Insurance, Aflac, Pet Insurance

o Staff Training and Development Opportunities

o Employee Referral Bonus program