Billing Specialist

Billing Specialist will support financial and program leadership in developing, implementing, and managing Medicaid billing processes for housing support services. Ensure compliance with Medicaid guidelines, manage service authorization and claims, improve billing accuracy and efficiency, and collaborate with various departments.

Responsibilities include:

• Managing Medicaid billing: processing, submitting, and tracking Medicaid service authorizations and claims complying with Medicaid rules.
• Ensuring timely claims submission and resolving denied/underpaid claims.
• Liaising with NJ Family Care and Managed Care Organizations for claim discrepancies.
• Coding and documentation management: reviewing client records for appropriate Medicaid coding and documentation in HMIS.
• Coordinating to meet Medicaid documentation requirements.
• Following-up on claims and resolving billing issues.
• Training and supporting staff on Medicaid billing, coding systems (CPT, ICD-10, HCPCS), and documentation.
• Participating in trainings and meetings offered by MCOs, HMIS, and Camden Coalition.
• Coordinating referrals and responding to inquiries.
• Generating billing reports, tracking KPIs, and supporting audits.
• Streamlining billing workflows and integrating with case management systems.
• Developing billing policies, ensuring staff compliance, and communicating Medicaid rule changes.
• Conducting audits and improving billing workflows based on performance data.
• Staying updated on Medicaid policies and ensuring compliance.
• Preventing duplicate billing between Medicaid and grants, coordinating with financial teams and Controller for audits.

Qualifications:

• Bachelor's degree in Accounting, Finance, Healthcare Administration, Social Work or related field.
• 2-3 years experience in Medicaid billing, healthcare administration preferred.
• Knowledge of Medicaid billing procedures, coding (CPT, ICD-10, HCPCS), payer platforms (Avility), and compliance.
• Experience with Efforts to Outcomes (ETO) software preferred.
• Proficient with Microsoft 365 (Word, Excel, Outlook, SharePoint).
• Strong analytical/problem-solving skills, communication skills, and detail-oriented.
• Valid NJ Driver's License.

Benefits include Medical, Dental, Vision, 403B Retirement Plan, Paid Time Off (Vacation, Sick, Personal & Ten Holidays).

Work schedule: Monday-Friday, 9:00 AM – 5:00 PM.

This position may offer a hybrid office/remote schedule option based on performance.