Billing Manager
About The Position
We are seeking an experienced Billing Manager with in-depth knowledge of Virginia Medicaid (DMAS) billing, specifically within the Behavioral Health and ARTS programs. This individual will oversee all aspects of revenue cycle management related to Virginia Medicaid and managed care organizations (MCOs), ensuring compliance, accuracy, and timely reimbursement. The ideal candidate has direct experience billing for ARTS levels of care (e.g., 2.1, 2.5, 3.1, OTP, etc.) and understands the regulatory and documentation standards required for successful claims submission and audit defense.
Requirements
- Minimum 3–5 years of direct experience billing Virginia Medicaid (DMAS)
- Demonstrated experience billing ARTS services (Level 2.1, 2.5, 3.1, OTP, etc.)
- Strong understanding of DMAS provider manuals and Medicaid fee schedules
- Experience working with Virginia Medicaid MCOs (e.g., UHC, Anthem, Aetna, Humana, Sentara)
- Knowledge of service authorization requirements and medical necessity standards
- Experience managing denials and appeals within ARTS programs
- Strong understanding of compliance and audit risk mitigation
- High attention to detail and ability to analyze billing trends
Nice To Haves
- Experience working within DBHDS-licensed programs
- Experience with behavioral health EHR systems
- Prior leadership or supervisory experience
- Familiarity with credentialing and enrollment processes
Responsibilities
- Oversee all Virginia DMAS billing operations for behavioral health and ARTS services
- Ensure accurate claim submission to DMAS and Virginia Medicaid MCOs
- Monitor claim denials, rejections, and appeals; implement corrective action strategies
- Maintain compliance with ARTS billing requirements
- Review documentation to ensure medical necessity and billing integrity
- Manage authorizations and ensure alignment with approved services
- Oversee revenue cycle metrics, including A/R, aging, and reimbursement trends
- Develop and implement billing policies and internal controls
- Coordinate with clinical leadership to address documentation or compliance issues
- Prepare for and respond to DMAS, MCO, and audit requests
- Supervise Virginia billing staff
Benefits
- 401(k)
- 401(k) matching
- Competitive salary
- Dental insurance
- Health insurance
- Opportunity for advancement
- Paid time off
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
