Heart to Heart is seeking a highly organized, detail-oriented and experienced Billing Specialist to join our Revenue Cycle Team. This position is responsible for the timely, accurate and compliant billing of Medicaid waiver services for individuals receiving Intellectual and Developmental Disabilities (IDD) services in New Jersey )Division of Developmental Disabilities - DDD) and Pennsylvania (Office of Developmental Programs - ODP).
The ideal candidate will possess strong knowledge of Medicaid billing regulations, revenue cycle processes and electronic billing systems. Experience with Therap, PROMISe and HCSIS is highly preferred. The successful candidate will be responsible for ensuring clean claims, minimizing denials, maximizing reimbursement and supporting the financial health of the organization.
Required Qualifications
- High School Diploma or equivalent required; Associate's or Bachelors degree preferred
- Minimum of two (2) years of medical billing, Medicaid billing or Revenue Cycle Management experience
- Strong understanding of claims processing, payment posting, accounts receivable and denial management
- Excellent organizational and analytical skills
- Strong written and verbal communication abilities
- High level of attention to detail and accuracy
- Ability to prioritize multiple deadlines in a fast paced environment
- Proficiency is Microsoft Office, particularly Excel
Preferred Qualifications
- Experience billing New Jersey Division of Developmental Disabilities (DDD) services
- Experience billing Pennsylvania Office of Developmental Programs (ODP) services
- Experience using Therap for service documentation, billing validation and provider workflows
- Experience using PROMISe for Pennsylvania Medicaid billing, claim inquiry, payment reconciliation and remittance review
- Experience navigating HCSIS (Home and Community Services Information System) to review authorizations, service plans, provider information and waiver services
- Knowledge of Electronic Visit Verification (EVV) requirements
- Experience billing residential, community-based, day habilitation, behavioral support, employment, respite and other waiver-funded IDD services
Technical Skills
- Therap
- PROMISe
- HCSIS
- Electronic Visit Verification (EVV) platforms
- Medicaid billing software
- Electronic Health Record (EHR) systems
- Clearinghouse claim submission portals
- Microsoft Excel (including filtering, pivot tables and reconciliation functions)
