Qureos Mentor

Maryville, Inc

Job Title: Revenue Cycle SpecialistLocation: South New Jersey Department: Finance / Revenue Cycle Reports To: CFO FLSA Status: ExemptPosition SummaryThe Revenue Cycle Specialist is responsible for supporting the full revenue cycle process for a nonprofit behavioral health organization, including client billing, claims submission, payment posting, and follow-up on outstanding accounts. This role ensures timely and accurate reimbursement from Medicaid, Medicare, and commercial payers while maintaining compliance with federal, state, and payer-specific regulations.In addition, this position supports EMR system maintenance related to billing functions and plays a key role in identifying revenue cycle issues, conducting root cause analysis, and contributing to process improvements that enhance overall financial performance.Key ResponsibilitiesBilling &amp; Claims Management<ul><li>Prepare and submit accurate claims to Medicaid, Medicare, and commercial insurance payers</li><li>Verify client insurance eligibility and benefits prior to service billing</li><li>Review documentation to ensure billing compliance with payer requirements</li><li>Correct and resubmit denied or rejected claims in a timely manner</li></ul>Accounts Receivable &amp; Collections<ul><li>Monitor accounts receivable and follow up on unpaid or underpaid claims</li><li>Work claim denials and underpayments, identifying trends and recurring issues</li><li>Communicate with payers regarding claim status and reimbursement issues</li><li>Maintain AR aging within organizational benchmarks</li></ul>Payment Posting &amp; Reconciliation<ul><li>Post insurance and client payments accurately and timely</li><li>Reconcile daily deposits and payment reports</li><li>Identify discrepancies and resolve payment issues</li></ul>EMR System Support &amp; Maintenance (Revenue Cycle Focus)<ul><li>Maintain accurate client demographic, insurance, and billing information within the EMR system</li><li>Perform routine audits of EMR data to ensure billing accuracy and compliance</li><li>Identify and correct data entry errors that impact claims submission and reimbursement</li><li>Assist with system updates, billing configuration changes, and payer setup as needed</li><li>Collaborate with IT or EMR vendors to troubleshoot billing-related system issues</li><li>Support staff with EMR billing workflows and best practices</li></ul>Root Cause Analysis &amp; Process Improvement<ul><li>Analyze claim denials, payment delays, and billing errors to determine root causes</li><li>Track and report trends in denials, rejections, and accounts receivable performance</li><li>Recommend and implement corrective actions to prevent recurring issues</li><li>Collaborate with clinical, intake, and administrative teams to improve documentation and workflow processes</li><li>Assist in developing and updating revenue cycle policies and standard operating procedures</li><li>Support continuous quality improvement initiatives to enhance efficiency, accuracy, and reimbursement rates</li></ul>Compliance &amp; Documentation<ul><li>Ensure compliance with Medicaid, Medicare, and State of New Jersey billing regulations</li><li>Maintain accurate and complete billing records</li><li>Support internal and external audits as needed</li></ul>Collaboration<ul><li>Work closely with clinical, intake/admissions, and finance teams to resolve billing issues</li><li>Educate staff on documentation requirements impacting reimbursement</li><li>Support organization-wide initiatives to strengthen revenue cycle performance</li></ul>QualificationsEducation &amp; Experience<ul><li>Bachelor&rsquo;s degree preferred (Healthcare Administration, Business, or related field)</li><li>5+ years of experience in healthcare billing, preferably in behavioral health or substance use treatment</li><li>Experience with Medicaid billing in New Jersey strongly preferred</li></ul>Knowledge, Skills &amp; Abilities<ul><li>Strong understanding of revenue cycle processes (billing, AR, collections)</li><li>Experience working within EMR/EHR systems (behavioral health platforms preferred)</li><li>Ability to analyze data, identify trends, and recommend process improvements</li><li>Knowledge of CPT, HCPCS, and ICD-10 coding basics</li><li>Attention to detail and strong organizational skills</li><li>Ability to manage multiple priorities and meet deadlines</li><li>Strong communication and problem-solving skills</li></ul>Preferred Qualifications<ul><li>Experience working in a nonprofit or community-based healthcare setting</li><li>Knowledge of New Jersey Medicaid (NJ FamilyCare) billing requirements</li><li>Experience with EMR systems such as Smart Care, Kipu</li><li>Certification such as Certified Billing and Coding Specialist (CBCS) or similar</li></ul>Work Environment<ul><li>Office-based or hybrid work environment</li><li>May require occasional overtime to meet billing deadlines</li></ul>Pay: $57,500.00 - $70,000.00 per yearBenefits:<ul><li>401(k)</li><li>401(k) matching</li><li>Dental insurance</li><li>Employee assistance program</li><li>Employee discount</li><li>Health insurance</li><li>Health savings account</li><li>Life insurance</li><li>Paid time off</li><li>Professional development assistance</li><li>Tuition reimbursement</li><li>Vision insurance</li></ul>Application Question(s):<ul><li>Revenue Cycle experience required greater than 3 years</li><li>EMR implementation experience greater than 3 years</li></ul>Ability to Commute:<ul><li>Voorhees, NJ 08043 (Preferred)</li></ul>Work Location: Hybrid remote in Voorhees, NJ 08043

Revenue Cycle Specialist

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Maryville, Inc

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Revenue Cycle Specialist