BEHAVIORAL HEALTH BILLING CODING SPECIALIST

About the role

Preferred Behavioral Health Group is a dynamic and innovative non-profit organization dedicated to changing lives and saving lives across New Jersey through a Trauma Informed Care culture. We are an award-winning team named one of “THE BEST PLACES TO WORK IN NEW JERSEY” for both 2024 and 2025 by NJBIZ. Our staff is at the core of everything we do, and we are committed to building a diverse team where employees feel valued and supported.

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 billing inquiries, including 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.

Competencies

• Minimum of 3 years of behavioral health medical billing coding experience.
• Experience in both for-profit and non-profit behavioral health settings is preferred.
• Proficiency with commercial, Medicare, Medicaid, state, and county payor portals.

Qualifications

• High school diploma or equivalent required.
• Billing Coding 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.
• Use a trauma-informed approach to all client financial concerns.
• Familiarity with claim submission processes, billing software, EHR/EMR systems.
• Strong problem-solving skills for resolving complex billing and reimbursement issues.

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

Location: Office, 52 Hyers Street, Toms River, New Jersey

Position Type: Full Time

Salary: $60,000.00 – $70,000.00