We are seeking a detail-oriented Medical Billing & Claims Specialist to support medical billing, claims processing, collections, and insurance follow-up. The ideal candidate will have hands-on experience with NJ Medicaid billing and a strong understanding of insurance claims, EOBs, CPT and ICD-10 coding, and UB-04 claim forms.
Export, import, and submit claims between billing systems
Perform medical billing collections and insurance follow-up
Review medical claims for accuracy and completeness
Research and resolve insurance denials and underpayments
Identify and resolve outstanding issues preventing claims from being paid
Review EOBs and insurance information
Complete accurate documentation and data entry
Meet established productivity and quality goals
Perform additional duties as assigned
NJ Medicaid billing experience required
Minimum of 6 months of medical billing experience
Working knowledge of EOBs and insurance processes
Understanding of CPT, ICD-10, and UB-04 claim forms
Experience working with an EMR system
Strong written and verbal communication skills
Excellent attention to detail and organizational skills
Strong problem-solving, research, and analytical abilities
Ability to meet productivity goals in a fast-paced environment
Proficiency with Microsoft Outlook, Word, and Excel
High school diploma or GED required
Experience with Navinet, PEAR, Availity, and/or EPIC
Additional experience with Medicaid claims, denials, payment discrepancies, and insurance follow-up
Monday-Friday
8:00 AM-4:30 PM OR
8:30 AM-5:00 PM
The ideal candidate is a detail-oriented medical billing professional with NJ Medicaid experience who is comfortable researching claims, resolving denials and underpayments, communicating with insurance companies, and working across multiple billing and EMR systems.
For California Applicants:
We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO) , and the California Fair Chance Act (CFCA).
This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.
