QA Billing and Administrative Support

Full-Time - Salary $55,000 | MondayFriday | 8:00 AM 4:00 PM | Medicaid Billing | Quality Assurance | IDD Services | DDDAbout 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 PurposeOpportunity to work in a mission-driven IDD organizationDirect involvement in Medicaid billing, audits, and compliance operationsExposure to DDD regulations, QA processes, and licensing standardsCareer growth in quality assurance, compliance, and healthcare administrationRequired Schedule Full-Time: Monday through FridayStandard daytime hours aligned with billing and audit cyclesEmployee Benefits Our House, Inc. offers competitive salaries and a comprehensive benefits package, including:Full-Time Benefits Include:Medical, prescription, dental, and vision insuranceLife & Accidental Death insuranceGenerous paid time off (vacation, personal, and sick time)Full-Time & Part-Time Benefits Include:Sick paid time offEmployee Assistance Plan (EAP)Flexible Spending Account (FSA)Matching 401(k) retirement planPet insuranceLegal shieldSupplemental Insurance plansTuition AssistancePublic Service Student Loan ForgivenessQualifications Bachelors degree in a related field requiredMinimum of 23 years of experience in Medicaid billing, QA, compliance, or administrative operations within IDD, behavioral health, or human servicesWorking knowledge of NJ DDD regulations, Office of Licensing standards, and Medicaid billing requirementsExperience with EHR systems such as iRecord, myEvolv, Therap, or similar platformsStrong understanding of: Individual Service Plans (ISPs)Service Detail Reports (SDRs)Authorization tracking and service validationExperience supporting or participating in incident management (UIR) processes preferredStrong attention to detail with the ability to identify discrepancies and ensure audit readinessAbility to manage weekly deadlines, billing cycles, and multiple prioritiesProficiency in Microsoft Office (Excel, Word, Outlook)Ability to maintain strict confidentiality and professionalismMedicaid Billing & Pre-Billing Audits Conduct weekly Medicaid pre-billing audits to ensure services meet DDD and Medicaid requirementsComplete Medicaid billing submissions in alignment with QA timelinesIdentify and resolve discrepancies related to authorizations, service delivery, and documentationISP, SDR & Documentation Management Review and validate Individual Service Plans (ISPs), Service Detail Reports (SDRs), and authorizationsEnsure all required documentation is accurate, complete, and audit-readyMaintain data integrity across iRecord, myEvolv, or similar systemsIncident Management (UIR) Serve as secondary UIR investigator when neededAssist with incident investigations, documentation, and follow-up reportingSupport compliance with DDD incident reporting requirements and timelinesMaintain integrity of the investigatory process and documentation standardsCompliance & Quality Assurance Ensure adherence to OHI policies, Medicaid regulations, and NJ DDD Manual of StandardsSupport internal audits and quality assurance reviewsMaintain compliance across all billing, documentation, and reporting processesCollaboration & Cross-Functional Support Work closely with program leadership, QA, and administrative teamsCommunicate documentation gaps or compliance issues to appropriate staffSupport program teams in maintaining accurate and timely documentationTravel Requirements Approximately 60% travel to program sites, trainings, and related activitiesEqual 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 SalaryPI3db7a698e437-26289-40487109