Preferred Behavioral Health Group · 3 weeks ago
SENIOR BILLING SPECIALIST
Toms River - Hyers St, Toms River, NJ, US
Full-time
Onsite
Senior Level
$65K/yr - $65K/yr
5+ years expPreferred Behavioral Health Group is a premier behavioral health organization in New Jersey, dedicated to changing lives through a Trauma Informed Care culture. The Senior Billing Specialist will ensure timely and accurate billing, payment posting, and account reconciliation across multiple payer systems, while maintaining compliance in a fast-paced environment.
Health CareHospitalMental HealthWellness
Responsibilities
Prepare and submit clean claims to various insurance companies either electronically or by paper
Prepare, review, and send patient statements
Answer questions from consumers, clinical/prescribers, clerical staff and insurance companies
Identifies and resolves consumers billing complaints
Assume the responsibility of receiving and sorting incoming payments with attention to credibility
Evaluate consumer’s financial status and establishes budget payment plans. Follows and reports status of delinquent accounts
Reviews account for possible assignment and makes recommendations to the Billing Manager or RCM Manager
Performs various collection actions including contacting consumers by phone, correcting and resubmitting claims to third party payers
Perform manual billing for services not supported by electronic systems, ensuring accuracy and completeness
Perform manual payment posting for non-electronic transactions
Prepare and issue invoices to external clients based on contractual terms and service delivery
Respond to client inquiries regarding invoices, payments, and billing discrepancies
Write thorough reports on billing activity with clear and reliable data
Maintains strictest confidentiality, adheres to all HIPAA guidelines/regulations
Work closely with the Accounting team to design, evaluate, and implement billing processes and system improvements
Adhere to New Jersey Medicaid billing guidelines for behavioral health services, including service authorization and documentation requirements (MCOs)
Maintain billing practices in accordance with NJ-specific CPT/HCPCS coding standards and reimbursement policies
Monitor updates from NJ Medicaid and commercial payers regarding behavioral health billing rules and rate changes
Support compliance with NJ Charity Care and sliding fee scale programs for eligible self-pay patients
Enter self-pay statement payments and Cognito payments into the billing system
Monitor and follow up on outstanding self-pay balances to reduce aging and improve collections
Performs monthly reporting on billing and collection status, and provide analysis as needed
Ensure posting of payments into computerized billing system and coordinates accurate interface of posted payments with general ledger system
Analyzes patient receivable reports and ensures prompt follow up on unpaid items
Acquires a thorough knowledge of the organization’s programs and billable services as well as a good working relationship with Program & Clinical Specialists
Support audits and compliance checks related to external and internal billing
Ensure compliance with federal, state (including NJ-specific), and payer-specific billing regulations
Identify opportunities for process improvements and contribute to billing system enhancements
Other duties assigned
Qualification
Required
High School Diploma or higher level of education
Excellent knowledge of MS Office, Excel, and EHR software
Proficiency with numbers and processing of financial information
5 years experience as a billing specialist
Preferred
Billing certification (CMRS or CPB)
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, such as Vision Insurance, Aflac, Pet Insurance
Staff Training and Development Opportunities
Employee Referral Bonus program
Company
Preferred Behavioral Health Group
Preferred Behavioral Health Group offers health services and programs for substance use and mental health of community people.
201-500 employees
Funding
Current Stage
Growth StageLeadership Team
Dr. Tara Chalakani
Chief Executive Officer
Recent News
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