Medicaid Billing Specialist – New Jersey Medicaid | Fully Remote | $55,000/year

Medicaid Billing Specialist – New Jersey Medicaid | Fully Remote | $55,000/year

Location: Fully Remote
Salary: $55,000 per year
Location Preference: First consideration given to New Jersey residents, followed by candidates residing in the Eastern Time Zone.

About the Opportunity

A national managed healthcare organization serving individuals covered by Medicaid, Medicare, and other government-sponsored health programs is seeking an experienced Medicaid Billing Specialist.

This fully remote opportunity is ideal for a detail-oriented billing professional with New Jersey Medicaid experience, preferably in home care, home health, or skilled nursing. The role focuses on accurate claims submission, service authorization management, and timely resolution of billing issues.

New Jersey Medicaid billing experience is required. Home care and/or skilled nursing billing experience is strongly preferred.

Key Responsibilities

- Manage billing for New Jersey Medicaid-funded home care services.

- Submit, review, and monitor claims through Medicaid and managed care organization (MCO) payer portals.

- Obtain, review, track, and maintain client service authorizations.

- Verify authorized hours, units, service codes, effective dates, and expiration dates.

- Confirm member eligibility and coverage before submitting claims.

- Review service records and supporting documentation for accuracy and consistency with authorizations.

- Identify and resolve authorization discrepancies, missing information, and billing errors.

- Monitor claim status and follow up on rejected, denied, unpaid, or underpaid claims.

- Prepare corrected claims and supporting documentation for resubmissions or appeals.

- Reconcile payments and remittance information, investigate discrepancies, and maintain accurate billing records.

- Coordinate with internal teams and payer representatives to resolve issues affecting reimbursement.

- Track outstanding claims, authorization renewals, and timely filing deadlines.

- Maintain confidentiality and follow applicable privacy requirements and organizational procedures.

Required Qualifications

- Experience billing New Jersey Medicaid, including familiarity with Medicaid and MCO payer portals.

- Working knowledge of claims submission, claim status tracking, denial resolution, and reimbursement follow-up.

- Experience reviewing and managing service authorizations.

- Ability to verify authorized hours, units, service codes, and coverage dates.

- Strong attention to detail, organizational skills, and follow-through.

- Clear written and verbal communication skills.

- Proficiency with billing software, electronic records, and Microsoft Excel.

- Ability to work independently in a remote environment and manage competing deadlines.

Preferred Qualifications

- Medicaid billing experience in home care, home health, and/or skilled nursing.

- Familiarity with New Jersey Medicaid managed care and long-term services and supports.

- Experience resolving claims affected by authorization limits, service documentation discrepancies, or eligibility issues.

Remote Location Preference

This position is fully remote. First preference will be given to qualified candidates residing in New Jersey. Qualified candidates elsewhere in the Eastern Time Zone will receive the next level of consideration.

Apply

Please submit your resume highlighting your New Jersey Medicaid billing experience, payer portal knowledge, and any background in home care, home health, or skilled nursing billing.