Revenue Cycle Specialist

Job Title: Revenue Cycle Specialist

Location: South New Jersey
Department: Finance / Revenue Cycle
Reports To: CFO
FLSA Status: Exempt

Position Summary

The 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 Responsibilities

Billing & Claims Management

• Prepare and submit accurate claims to Medicaid, Medicare, and commercial insurance payers
• Verify client insurance eligibility and benefits prior to service billing
• Review documentation to ensure billing compliance with payer requirements
• Correct and resubmit denied or rejected claims in a timely manner

Accounts Receivable & Collections

• Monitor accounts receivable and follow up on unpaid or underpaid claims
• Work claim denials and underpayments, identifying trends and recurring issues
• Communicate with payers regarding claim status and reimbursement issues
• Maintain AR aging within organizational benchmarks

Payment Posting & Reconciliation

• Post insurance and client payments accurately and timely
• Reconcile daily deposits and payment reports
• Identify discrepancies and resolve payment issues

EMR System Support & Maintenance (Revenue Cycle Focus)

• Maintain accurate client demographic, insurance, and billing information within the EMR system
• Perform routine audits of EMR data to ensure billing accuracy and compliance
• Identify and correct data entry errors that impact claims submission and reimbursement
• Assist with system updates, billing configuration changes, and payer setup as needed
• Collaborate with IT or EMR vendors to troubleshoot billing-related system issues
• Support staff with EMR billing workflows and best practices

Root Cause Analysis & Process Improvement

• Analyze claim denials, payment delays, and billing errors to determine root causes
• Track and report trends in denials, rejections, and accounts receivable performance
• Recommend and implement corrective actions to prevent recurring issues
• Collaborate with clinical, intake, and administrative teams to improve documentation and workflow processes
• Assist in developing and updating revenue cycle policies and standard operating procedures
• Support continuous quality improvement initiatives to enhance efficiency, accuracy, and reimbursement rates

Compliance & Documentation

• Ensure compliance with Medicaid, Medicare, and State of New Jersey billing regulations
• Maintain accurate and complete billing records
• Support internal and external audits as needed

Collaboration

• Work closely with clinical, intake/admissions, and finance teams to resolve billing issues
• Educate staff on documentation requirements impacting reimbursement
• Support organization-wide initiatives to strengthen revenue cycle performance

Qualifications

Education & Experience

• Bachelor’s degree preferred (Healthcare Administration, Business, or related field)
• 5+ years of experience in healthcare billing, preferably in behavioral health or substance use treatment
• Experience with Medicaid billing in New Jersey strongly preferred

Knowledge, Skills & Abilities

• Strong understanding of revenue cycle processes (billing, AR, collections)
• Experience working within EMR/EHR systems (behavioral health platforms preferred)
• Ability to analyze data, identify trends, and recommend process improvements
• Knowledge of CPT, HCPCS, and ICD-10 coding basics
• Attention to detail and strong organizational skills
• Ability to manage multiple priorities and meet deadlines
• Strong communication and problem-solving skills

Preferred Qualifications

• Experience working in a nonprofit or community-based healthcare setting
• Knowledge of New Jersey Medicaid (NJ FamilyCare) billing requirements
• Experience with EMR systems such as Smart Care, Kipu
• Certification such as Certified Billing and Coding Specialist (CBCS) or similar

Work Environment

• Office-based or hybrid work environment
• May require occasional overtime to meet billing deadlines

Pay: $57,500.00 - $70,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Employee discount
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Professional development assistance
• Tuition reimbursement
• Vision insurance

Application Question(s):

• Revenue Cycle experience required greater than 3 years
• EMR implementation experience greater than 3 years

Ability to Commute:

• Voorhees, NJ 08043 (Preferred)

Work Location: Hybrid remote in Voorhees, NJ 08043