Reporting to the Director of Finance, the Medicaid Billing Specialist will ensure the accurate and timely submission of claims to New Jersey FamilyCare (Medicaid), resolve discrepancies, and manage accounts receivable for a nonprofit housing/homelessness agency providing a limited range of Medicaid services. This role requires solid understanding of complex federal and state regulations, healthcare coding conventions, and billing software. Familiarity with Medicaid Health-Related Social Needs (HRSN) programs or similar Medicaid programs is a plus.

Key duties include:

Preparing, reviewing, and submitting claims to NJ Medicaid Managed Care Organizations (MCOs) using electronic billing systems compliant with payer-specific guidelines.
Monitoring claim status, researching rejected or denied claims, correcting errors, and resubmitting.
Collaborating with program managers and direct service staff to ensure documentation supports billed services and proper billing codes are used.
Accurate payment posting, adjustments, and denial reconciliation.
Analyzing aging reports, researching outstanding accounts, and taking action to secure payment.
Maintaining patient information confidentiality per HIPAA, staying updated on Medicaid policy changes, and preparing management reports.
Collaborating to improve systems ensuring regulatory compliance and supporting program growth.

Key qualifications:

2+ years healthcare billing experience, specifically Medicaid.
Knowledge of Medicaid regulations and coding terminology preferred.
Proficiency with billing software, electronic care management systems, and Microsoft Office.
Strong attention to detail, analytical and organizational skills, excellent communication.
High school diploma required; Associate or Bachelor’s degree preferred.
Certifications like Certified Professional Biller (CPB) advantageous.

Work Location: In person in Rahway, NJ.

Salary: $60,000 per year.