Medical Billing Specialist

Job Description

Job Description

About Us

Cornerstone Comprehensive Therapy Center is a growing ABA (Applied Behavior Analysis) therapy provider in Central New Jersey. We are looking for a top-tier Billing Specialist to manage our end-to-end claim submission process.

Work Structure

This is a hybrid role offering work-from-home flexibility. However, you must reside within commuting distance of Central NJ, as you will be required to come into our Metuchen and Hamilton offices for meetings, training, or administrative tasks. Candidates living between these two locations are highly preferred.

The Medical Billing Specialist plays a vital role within the billing department, managing both individual and team-based tasks to ensure accurate processing of patient billing information. This position involves frequent interaction with insurance companies to verify coverage, process claims, and address denials, all while maintaining compliance with healthcare regulations and confidentiality standards.

Responsibilities

• Process and submit insurance claims accurately and timely
• Verify patient insurance eligibility and coverage details
• Generate and send patient billing statements
• Reconcile accounts to ensure correct billing and payments
• Monitor compliance with healthcare billing regulations and HIPAA standards
• Communicate effectively with patients and insurance representatives
• Manage claim denials and initiate appeals as necessary
• Maintain accurate and organized billing records

Preferred Qualifications

• 3+ years of experience in medical billing
• Knowledge of Medical Coding (CPT, ICD-10)
• Experienced in insurance claim processing
• Strong attention to detail and problem-solving skills
• Familiarity with HIPAA compliance requirements

Key Responsibilities

• Manage end-to-end electronic and paper insurance claim submissions.
• Familiar with Tebra and Availity for eligibility, claim tracking, and troubleshooting.
• Review, analyze, and appeal denied claims.
• Post insurance payments (ERAs/EOBs) and verify patient benefits.

Qualifications

• Required Software Experience: Mastery of Availity and Tebra.
• Experience: 3+ years of medical/behavioral health billing (ABA experience is a plus).
• Location: Must live in Central NJ and be able to commute to both office locations.
• Deep understanding of clearinghouses, prior authorizations, and commercial/Medicaid appeals.

Benefits & Perks

• Premium Pay: $50.00/hour.
• Flexibility: Hybrid schedule (work from home with occasional office days).
• Growth: Initial part-time hours with a path to transition to a full-time role (with benefits).