MOHR Talent
Behavioral Health Billing Specialist (Medicaid and MCO focused)
MOHR Talent, Trenton, New Jersey, United States
Behavioral Health Billing Specialist (Medicaid and MCO focused)
Location:
Central New Jersey Schedule:
Onsite | Monday–Friday | 8:00 AM–5:00 PM
We’re hiring a
Billing Specialist
to support day-to-day billing and reimbursement operations for a well‑established, mission‑driven healthcare organization. This role plays a critical part in maintaining accurate cash flow by managing claims, posting payments, resolving denials, and working directly with Medicaid Managed Care Organizations (MCOs). This role is best suited for someone with
hands‑on Medicaid and MCO billing experience , particularly in behavioral health, community health, or outpatient care settings.
What You’ll Do
Billing & Claims
Prepare and submit clean electronic and paper claims
Bill services using correct CPT/HCPCS codes, modifiers, and ICD‑10 diagnoses
Submit claims directly to
Medicaid Managed Care Organizations (MCOs)
Post insurance payments and reconcile EOBs
Prepare daily deposits and maintain accurate payment records
Medicaid & MCO Billing Responsibilities
Verify Medicaid eligibility and confirm assigned MCO prior to billing
Track and manage prior authorizations and service limits
Follow up on rejected or denied MCO claims
Correct coding, authorization, or documentation issues and resubmit claims
Assist with appeals related to medical necessity, authorization, or timely filing
Help ensure documentation supports billed services and audit readiness
Accounts & Reporting
Prepare and send patient statements
Monitor delinquent accounts and assist with payment plans
Generate billing and aging reports to support monthly close
Identify trends in denials or underpayments and elevate as needed
Compliance & Collaboration
Maintain strict HIPAA compliance and confidentiality
Work with Finance and program teams to improve billing accuracy and processes
Support ongoing improvements to billing workflows and systems
What We’re Looking For
Required
High School Diploma (additional education a plus)
Experience in
medical billing , preferably behavioral health or community health
Direct experience with
Medicaid billing and Managed Care Organizations (MCOs)
Strong Excel skills (filtering, formulas; pivot tables a plus)
Experience with EHR or billing systems
Knowledge of insurance verification, claims submission, and payer guidelines
Strong attention to detail and ability to work independently
Professional communication and customer‑service mindset
Benefits
Health, dental, and vision insurance
Retirement plan (403(b))
Paid time off and holidays
Stable, professional, team‑oriented environment
Equal Opportunity Statement MOHR Talent is an equal‑opportunity employer and complies with all applicable federal, state, and local nondiscrimination laws. We provide equal employment opportunities regardless of race, color, religion, sex, national origin, age, disability, marital status, sexual orientation, gender identity, genetic information, military/veteran status, or any other protected status.
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Central New Jersey Schedule:
Onsite | Monday–Friday | 8:00 AM–5:00 PM
We’re hiring a
Billing Specialist
to support day-to-day billing and reimbursement operations for a well‑established, mission‑driven healthcare organization. This role plays a critical part in maintaining accurate cash flow by managing claims, posting payments, resolving denials, and working directly with Medicaid Managed Care Organizations (MCOs). This role is best suited for someone with
hands‑on Medicaid and MCO billing experience , particularly in behavioral health, community health, or outpatient care settings.
What You’ll Do
Billing & Claims
Prepare and submit clean electronic and paper claims
Bill services using correct CPT/HCPCS codes, modifiers, and ICD‑10 diagnoses
Submit claims directly to
Medicaid Managed Care Organizations (MCOs)
Post insurance payments and reconcile EOBs
Prepare daily deposits and maintain accurate payment records
Medicaid & MCO Billing Responsibilities
Verify Medicaid eligibility and confirm assigned MCO prior to billing
Track and manage prior authorizations and service limits
Follow up on rejected or denied MCO claims
Correct coding, authorization, or documentation issues and resubmit claims
Assist with appeals related to medical necessity, authorization, or timely filing
Help ensure documentation supports billed services and audit readiness
Accounts & Reporting
Prepare and send patient statements
Monitor delinquent accounts and assist with payment plans
Generate billing and aging reports to support monthly close
Identify trends in denials or underpayments and elevate as needed
Compliance & Collaboration
Maintain strict HIPAA compliance and confidentiality
Work with Finance and program teams to improve billing accuracy and processes
Support ongoing improvements to billing workflows and systems
What We’re Looking For
Required
High School Diploma (additional education a plus)
Experience in
medical billing , preferably behavioral health or community health
Direct experience with
Medicaid billing and Managed Care Organizations (MCOs)
Strong Excel skills (filtering, formulas; pivot tables a plus)
Experience with EHR or billing systems
Knowledge of insurance verification, claims submission, and payer guidelines
Strong attention to detail and ability to work independently
Professional communication and customer‑service mindset
Benefits
Health, dental, and vision insurance
Retirement plan (403(b))
Paid time off and holidays
Stable, professional, team‑oriented environment
Equal Opportunity Statement MOHR Talent is an equal‑opportunity employer and complies with all applicable federal, state, and local nondiscrimination laws. We provide equal employment opportunities regardless of race, color, religion, sex, national origin, age, disability, marital status, sexual orientation, gender identity, genetic information, military/veteran status, or any other protected status.
#J-18808-Ljbffr