Medical Biller (Medicaid & MCO - Behavioral Health)

Better Morning is an outpatient behavioral health practice certified as a Core Service Agency by the DC Department of Behavioral Health, focusing on evidence-based programs for at-risk youth and underserved populations.

The Medicaid & MCO Biller is responsible for accurate, timely submission, tracking, and reconciliation of claims for DC Medicaid and Managed Care Organizations (MCOs), ensuring compliance with DC Department of Health Care Finance regulations and payer-specific billing requirements.

Key responsibilities include:

• Verifying Medicaid eligibility and MCO enrollment prior to claim submission.
• Managing prior authorizations and coverage limitations.
• Submitting claims using proper CPT, HCPCS, and ICD-10 codes for behavioral health services.
• Reviewing and resolving denied or rejected claims and managing appeals.
• Posting payments and reconciling accounts receivable.
• Maintaining billing compliance and audit-ready documentation.
• Collaborating with clinical and care coordination teams to ensure complete billing documentation.

Technical skills required:

• Knowledge of CPT, ICD-10, and HCPCS coding.
• Familiarity with EHR systems such as Credible Behavioral Health.
• Proficiency in Office 365.

Preferred qualifications:

• Experience in CARF-accredited organizations.
• Familiarity with behavioral health services (CSS, CBI, ACT, Medication Management, ICC).
• Certified Professional Biller (CPB) certification is a plus.

Qualifications:

• High school diploma required; Associate’s or Bachelor’s degree preferred.
• 2+ years of Medicaid billing experience, preferably in behavioral health or community services.
• Strong knowledge of DC Medicaid and MCO billing.