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QA Billing and Administrative Support
- Berkeley Heights, New Jersey, United States
- Berkeley Heights, New Jersey, United States
Über
About Our House, Inc. At Our House, Inc., our mission is to provide healthy, stimulating, and inclusive environments for individuals with intellectual and developmental disabilities (IDD). Through residential, day, and community-based services, we support individuals in building independence, stability, and meaningful lives.
Our Quality Assurance and Systems teams are responsible for ensuring Medicaid billing accuracy, audit readiness, and compliance with New Jersey Division of Developmental Disabilities (DDD) and Office of Licensing standards. This position is ideal for candidates currently working in IDD, behavioral health, or human services organizations who have experience with Medicaid billing, ISP documentation, audits, and incident management systems.
Position Summary (Medicaid Billing Specialist | QA | Compliance | IDD | DDD Services) The Billing and Administrative Support Specialist supports the Systems Manager and QA team by ensuring accurate Medicaid billing, pre-billing audits, and compliance with DDD and Office of Licensing standards. This role is responsible for weekly audit cycles, Medicaid billing submission, ISP and Service Detail Report validation, and maintaining compliance across electronic systems such as iRecord and myEvolv.
This position also supports Unusual Incident Reporting (UIR) and investigations, making it ideal for candidates with experience in incident management, QA review, or compliance coordination within IDD services.
This is a high-accountability role where accuracy, timelines, and regulatory compliance directly impact funding and program operations.
What Youll Gain A Career with Purpose
Opportunity to work in a mission-driven IDD organization
Direct involvement in Medicaid billing, audits, and compliance operations
Exposure to DDD regulations, QA processes, and licensing standards
Career growth in quality assurance, compliance, and healthcare administration
Required Schedule Full-Time: Monday through Friday Standard daytime hours aligned with billing and audit cycles
Employee Benefits Our House, Inc. offers competitive salaries and a comprehensive benefits package, including:
Full-Time Benefits Include:
Medical, prescription, dental, and vision insurance Life & Accidental Death insurance Generous paid time off (vacation, personal, and sick time)
Full-Time & Part-Time Benefits Include:
Sick paid time off Employee Assistance Plan (EAP) Flexible Spending Account (FSA) Matching 401(k) retirement plan Pet insurance Legal shield Supplemental Insurance plans Tuition Assistance Public Service Student Loan Forgiveness
Qualifications
Bachelors degree in a related field required
Minimum of 23 years of experience in Medicaid billing, QA, compliance, or administrative operations within IDD, behavioral health, or human services
Working knowledge of NJ DDD regulations, Office of Licensing standards, and Medicaid billing requirements
Experience with EHR systems such as iRecord, myEvolv, Therap, or similar platforms
Strong understanding of:
Individual Service Plans (ISPs)
Service Detail Reports (SDRs)
Authorization tracking and service validation
Experience supporting or participating in incident management (UIR) processes preferred
Strong attention to detail with the ability to identify discrepancies and ensure audit readiness
Ability to manage weekly deadlines, billing cycles, and multiple priorities
Proficiency in Microsoft Office (Excel, Word, Outlook)
Ability to maintain strict confidentiality and professionalism
Medicaid Billing & Pre-Billing Audits
Conduct weekly Medicaid pre-billing audits to ensure services meet DDD and Medicaid requirements
Complete Medicaid billing submissions in alignment with QA timelines
Identify and resolve discrepancies related to authorizations, service delivery, and documentation
ISP, SDR & Documentation Management
Review and validate Individual Service Plans (ISPs), Service Detail Reports (SDRs), and authorizations
Ensure all required documentation is accurate, complete, and audit-ready
Maintain data integrity across iRecord, myEvolv, or similar systems
Incident Management (UIR)
Serve as secondary UIR investigator when needed
Assist with incident investigations, documentation, and follow-up reporting
Support compliance with DDD incident reporting requirements and timelines
Maintain integrity of the investigatory process and documentation standards
Compliance & Quality Assurance
Ensure adherence to OHI policies, Medicaid regulations, and NJ DDD Manual of Standards
Support internal audits and quality assurance reviews
Maintain compliance across all billing, documentation, and reporting processes
Collaboration & Cross-Functional Support
Work closely with program leadership, QA, and administrative teams
Communicate documentation gaps or compliance issues to appropriate staff
Support program teams in maintaining accurate and timely documentation
Travel Requirements Approximately 60% travel to program sites, trainings, and related activities
Equal Opportunity Employer Our House, Inc. is an Equal Opportunity Employer committed to diversity, equity, and inclusion. All qualified applicants will receive consideration without regard to protected characteristics.
Employment Disclosure This job description does not constitute a contract. Duties and requirements may change at the discretion of Our House, Inc. Employment is at-will. Compensation details: 55000-55000 Yearly Salary PI55bc14904f13-26289-40487109
Sprachkenntnisse
- English
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