Position Overview
Preferred Behavioral Health Group is seeking an experienced, detail-oriented Behavioral Health Medical Billing Coding Specialist to join the Billing Department in Toms River, New Jersey. This full-time role is focused on managing behavioral health billing and coding processes, supporting claim submission, denial resolution, compliance, and reimbursement workflows in a complex payer environment.
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 claim follow-up.
- Review payer rejections and clearinghouse reporting.
- Maintain current knowledge of billing codes, compliance guidelines, and regulatory changes.
- Ensure compliance with all federal, state, and local billing regulations.
- Review and send patient statements and manage delinquent accounts.
- Communicate with clients regarding billing inquiries, payment options, client hardships, and 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.
Requirements & Qualifications
Qualifications
- Minimum of 3 years of behavioral health medical billing coding experience.
- Experience in both for-profit and non-profit behavioral health settings preferred.
- Proficiency with commercial, Medicare, Medicaid, state, and county payor portals.
- High school diploma or equivalent required.
- Billing coding certificates such as CPB, CMRS, or equivalent preferred.
Knowledge and Skills
- In-depth understanding of CPT, ICD-10, and HCPCS coding standards.
- Proficiency in medical office systems and billing software.
- Knowledge of clearinghouse workflows; Inovalon experience preferred.
- Strong understanding of payer regulations and behavioral health billing requirements.
- Familiarity with claim submission processes and EHR/EMR systems.
- Strong problem-solving skills for resolving complex billing and reimbursement issues.
Benefits & Perks
Benefits
- Medical, dental, and prescription insurance
- 403(b) retirement plan
- Generous paid time off and paid holidays
- Long-term disability insurance
- Life and AD&D insurance
- Employee assistance program
- Flexible spending account and health savings account
- Voluntary benefits including vision insurance, Aflac, and pet insurance
- Staff training and development opportunities
- Employee referral bonus program
Location
New Jersey, US
Employment Type
Full-time
Experience Level
Intermediate Level
Salary Range
$60,000 - $70,000
Remote work allowed
No
Posted
2 weeks ago
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