Quality Assurance and Billing Coordinator

New Brunswick Counseling Center (NBCC) is seeking a meticulous and organized Quality Assurance and Billing Coordinator to join our dynamic team. This essential role supports administrative, clinical, and medical services through rigorous quality assurance practices and efficient billing management, ensuring compliance and maximizing operational effectiveness.

Responsibilities:

Quality Assurance Tasks:

• Monitor eligibility of all Medicaid patients through the New Jersey Medical Assistance Program’s Medical Eligibility Verification Service.


• Regularly verify patient insurance eligibility (Medicaid, Medicare, private carriers) and update eligibility status within the Agency’s Electronic Health Record (EHR).


• Track and update Medicaid authorizations, notify clinical staff of required extensions, and manage prior authorizations within the EHR.


• Screen and submit claims through NJDAS for the SAPTI/NJSI programs.


• Collaborate on Fee-for-Service (FFS) authorization requests and maintain updated billing rosters.


• Prepare and provide FFS billing totals and summaries to the CFO as required.


• Track intakes, manage FFS authorization requests for new patients, and update funding information for Medicaid recipients.


• Conduct weekly updates to ensure patient compliance with funding source requirements.


• Oversee tracking of Department of Children and Families (DCF) Service Authorization Requests (SARs), coordinate specimen screen authorizations, and serve as primary contact for DCF UDS reports.


• Generate "Unable to Bill Notices" when clients do not comply with billing requirements.


• Prepare and submit monthly invoices to the Department of Corrections (including BCJ, Fort Dix, Middlesex County, and UCHC).


• Prepare and submit monthly invoices for the Middlesex County Grant.


• Produce and submit weekly billing reports for Work First New Jersey.


• Monitor Work First New Jersey-funded clients, ensuring timely updates of Client Service Reviews (CSRs) and prior authorizations.


• Oversee and manage billing processes related to the Mobile Unit program.


• Verify funding sources during the intake process, alert admissions staff of discrepancies, and document these in client charts.


• Conduct routine quality assurance audits of administrative, clinical, and medical documentation to ensure accuracy, compliance, and completeness.


• Identify documentation errors or discrepancies and coordinate corrective actions with relevant staff.


• Provide training and ongoing support to administrative and clinical teams on documentation standards, compliance requirements, and billing practices.


• Attend all required administrative meetings and training sessions related to quality assurance and billing responsibilities.


• Conduct audits to ensure staff are scheduling appointments appropriately and provide reports on direct service hours completed.


• Identify areas for improvement, recommend corrective actions.

Qualifications:

• Minimum of 2 years’ experience in healthcare billing, administrative services, or quality assurance, preferably in behavioral health settings.


• Familiarity with Medicaid, Medicare, and private insurance billing requirements.


• Experience with Electronic Health Records (EHR) systems.

Requirements:

• Strong proficiency in Microsoft Office Suite (Word, Excel, PowerPoint) and Adobe Acrobat.


• Excellent communication, analytical, and organizational skills.


• High attention to detail, accuracy, and confidentiality.


• Ability to effectively manage multiple tasks and prioritize responsibilities independently and collaboratively.

Benefits & Perks:

• Potential opportunity for professional growth within the organization.


• Employer-contributed 401(k) retirement plan.