Behavioral and Mental Health Billing Specialist (Medicaid)

Job Description Job Description Salary: $20.00 - $25.00 Overview: We are seeking a dedicated and detail-oriented Behavioral and Mental Health Billing Specialist with extensive knowledge and experience in Medicaid billing. This role is pivotal in ensuring accurate and timely billing for behavioral and mental health services, including compliance with Medicaid regulations. The ideal candidate will have a strong understanding of billing procedures, insurance verification, and claims resolution within the context of behavioral health.

Key Responsibilities:

Medicaid Billing Management: Accurately prepare and submit Medicaid claims for behavioral and mental health services. Ensure compliance with state and federal Medicaid regulations, including documentation and coding requirements.

Insurance Verification and Pre-Authorization: Verify patient eligibility and benefits for Medicaid and other insurance plans. Secure pre-authorizations for behavioral health services as required.

Coding and Documentation: Use appropriate CPT, ICD-10, and HCPCS codes for mental health and behavioral services. Collaborate with providers to ensure documentation supports billing codes.

Claims Follow-Up and Resolution: Monitor claim statuses, identify denials, and take corrective actions to resubmit claims promptly. Communicate with Medicaid representatives to resolve billing discrepancies or issues.

Reporting and Analysis: Prepare detailed billing and revenue reports to identify trends and improve processes. Track key performance metrics related to Medicaid claims.

Compliance and Auditing: Stay updated on Medicaid policies and changes that affect billing processes. Participate in internal audits to ensure adherence to Medicaid guidelines and organizational policies.

Qualifications:

Proven experience in Medicaid billing, particularly in behavioral and mental health settings. Proficiency with medical billing software and electronic health records (EHR) systems. In-depth knowledge of CPT, ICD-10, and HCPCS coding for behavioral health services. Familiarity with Medicaid policies, including state-specific regulations. Strong analytical and problem-solving skills. Excellent communication and organizational abilities. Certification in medical billing or coding is a plus (e.g., CPC, CPB).

Preferred Qualifications:

Experience working in a behavioral health clinic or mental health organization. Knowledge of payer-specific guidelines for private insurance and Medicaid. Ability to train and educate staff on billing compliance and best practices.

Why Join Us? Be a part of a dynamic team committed to improving lives through accessible behavioral and mental health services. Your expertise in Medicaid billing will directly contribute to our mission of delivering high-quality care to those who need it most.

Application Process: If you are passionate about Medicaid billing and have a keen eye for detail, wed love to hear from you. Apply today to join our team!