Medical Biller/Quality Assurance

• Be a key player in implementation, including of the billing module, billing builder, through our Electronic Health Record (EHR) - FOOTHOLD AWARDS. Some duties include but are not limited to data entry and configuring activities.
• Overseeing billing through our EHR including entering charges and submitting claims as well as additional set up tasks including:
  • Setting up fiscal periods
  • Configuring payers and billing types
  • Inputting billing groups and billing info
  • Data entry of billing rates
  • Additional tasks as may be required
• Ensure activities outlined in the Policy and Procedure Manual are followed for programmatic areas including:
  • Direct-care service that was provided has a valid prior authorization
  • Claims include participant information and service information (such as Medicaid ID, diagnosis, procedure code, rate etc.) which can be found within the service plan and service detail report
• Service is properly documented along with any deliverable documents necessary to substantiate the claim in the case of an audit (such as strategies, time sheets, behavior plans)
• Handle accounts receivable reconciliation, claims corrections, and resubmission process
• Interact with payers(e.g. Medicaid, Insurers)
• Generate reports to be used to upload summary data on billing and accounts receivable into ESCNJchart of accounts
• Data entry from Billing builder to the agency accounting system
• Work as a team member of the Business Office
• Assist with Medicaid and DDD audits as required
• Maintain electronic and paper files of reports for internal and external uses
• Act as liaison between the DDD, CMS and ESCNJ, attending meetings, seminars, webinars and in-service training sessions offered by the Division of
• Developmental Disabilities as well as Centers for Medicare and Medicaid
• Oversee and ensure compliance with ESCNJ and CMS and DDD Policy and Procedures.
• Write updates to ESCNJ Policy and Procedure manual as needed. 
• Be a key player in the new hire orientation as well as provide support and training to staff including supervisors, case managers, and daily livings skills to ensure ability to implement  electronic record keeping technique

• Knowledge of general billing practices and familiarity of International Classification of Disease (ICD) 10
• Knowledge of Microsoft Office/ Word and Excel and email required
• Comfort in learning new tasks as needed
• Knowledge and comfort with working in an organization serving individuals with Intellectual and developmental disabilities
• Ability to use a computer to record activities, track equipment needs and communicate with management.
• Computer literate
• Detail oriented
• Experience in EHR a plus

• Experience in field of developmental disabilities preferable.
•  Knowledge of state and federal regulatory agencies affecting individuals with disabilities.
•  Experience training staff
•  Supervisory skills
• College Degree in related field

• Learns and follows the Agency's policies and procedures by attending mandatory in-service programs given by the Agency.
• Responsible for full understanding of emergency procedures.  He/she will perform specific duties designated to him/her, which includes but is not limited to, climbing and descending all flights of stairs throughout the facility while carrying up to sixty (60) lbs. 
• Uses the English language (oral and written) to report any incident or accident involving individuals served or oneself, as well as all unusual, questionable or dangerous situations to the management immediately.  Provides all information necessary to assist in completing the required report and/or provides a written statement
• Reports immediately to the Director of Administration or the Executive Director, any suspicion of verbal, physical, sexual abuse or neglect of ESCNJ clients or staff.
•  Reports immediately to the Director of Administration or the Executive Director, any unusual inappropriate or potentially harmful behavior on the part of anyone visiting an individual at any of the ESCNJ sites.
• Maintains confidentiality of organizational and individual information.
• Promotes the Agency's mission and policies at all times.
• Maintains personal hygiene.
• Demonstrates concern and courtesy to staff and visitors.

To apply for this position with the Educational Services Commission of New Jersey please visit the Human Resources Tab at www.escnj.us and click the employment opportunities link.

                                                                                                                                                                                                ESCNJ is an EOE/AA Employer