Better Morning emerged as an outpatient behavioral health practice in Ashburn, VA in 2014. The organization provides counseling and is a certified provider for intensive in home and community-based services (IHCBS) for at-risk youth in the District of Columbia. It is certified as a Core Service Agency (CSA) by the DC Department of Behavioral Health since 2017.
The Medicaid & MCO Biller is responsible for accurate and timely submission, tracking, and reconciliation of claims billed to DC Medicaid and Managed Care Organizations (MCOs). The role ensures compliance with District of Columbia Department of Health Care Finance regulations and payer-specific billing requirements while supporting revenue cycle efficiency.
Key responsibilities include verifying Medicaid eligibility, confirming MCO enrollment, managing prior authorizations, submitting claims using correct CPT, HCPCS, and ICD-10 codes for behavioral health services, managing denial follow-ups, posting payments and reconciling accounts receivable, maintaining compliance and documentation for audits, and collaborating with clinical and intake teams.
Technical skills needed are knowledge of CPT, ICD-10, and HCPCS coding, familiarity with EHR systems (such as Credible Behavioral Health), and proficiency in Office 365.
This position requires strong attention to detail, knowledge of DC Medicaid regulations, problem-solving skills for denial resolution, and ability to manage multiple payers and deadlines.
- High school diploma required; Associate's or Bachelor's degree preferred.
- 2+ years of Medicaid billing experience, preferably in behavioral health or community-based services.
- Knowledge of CPT, ICD-10, and HCPCS coding.
- Familiarity with DC Medicaid regulations and MCO policies.
- Experience with CARF-accredited organizations is preferred.
- Certification such as Certified Professional Biller (CPB) is a plus.
Location
Washington, District of Columbia, US
Employment Type
Full-time
Experience Level
Entry Level
Remote work allowed
No
Posted
4 weeks ago