Medical Biller
- Submit and manage claims for Virginia Medicaid (DMAS) behavioral health services
- Process ARTS claims for levels of care including 2.1, 2.5, 3.1, 3.5, OTP, and outpatient services
- Verify authorizations and ensure claims align with approved services
- Monitor claim rejections and denials; initiate corrections and resubmissions
- Prepare and track appeals for denied claims
- Post payments and reconcile remittance advice
- Maintain accurate billing records and documentation
- Communicate with Medicaid MCOs regarding claim status and resolution
- Work closely with clinical staff to resolve documentation discrepancies
- Assist in preparing documentation for audits or payer reviews
- Minimum 2–3 years of direct experience billing Virginia Medicaid (DMAS)
- Experience billing behavioral health and ARTS services required
- Knowledge of DMAS fee schedules, service authorization processes, and MCO billing systems
- Experience working with Virginia Medicaid MCOs (e.g., Carelon, Anthem, Aetna, Molina, etc.)
- Strong understanding of medical necessity documentation standards
- Familiarity with EHR billing systems
- Strong attention to detail and organizational skills
- Experience in DBHDS-licensed programs
- Knowledge of Virginia regulatory billing requirements
- Experience with claim auditing and compliance review
- Accuracy and attention to detail
- Understanding of Medicaid compliance requirements
- Ability to manage multiple claims and deadlines
- Strong communication and follow-up skills
- Problem-solving and denial resolution expertise
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