Billing Specialist
About The Position
The Billing Specialist is responsible for managing the full revenue cycle for substance use disorder (SUD) and behavioral health services in the 1525 Marion Barry Avenue programs, including claims submission, payment posting, denial management, and account reconciliation. Utilizing eClinicalWorks (ECW), the Billing Specialist ensures timely and accurate billing to Medicaid, Medicare, and third-party payers in accordance with DC Department of Behavioral Health (DBH) requirements and applicable federal and District regulations. The role requires close collaboration with clinical and administrative staff to support accurate documentation, authorization, and reimbursement of services.
Requirements
- 2+ years of medical billing experience required
- Hands-on experience with eClinicalWorks (eCW) required, including claims submission, payment posting, and reporting modules.
- Proficiency in MS Office applications (Word, Outlook, Excel, Adobe) and various business software.
- Legally authorized to work in the U.S.A.
Nice To Haves
- High school diploma or GED preferred
- Associate's or Bachelor's degree in healthcare administration, accounting, business, or related field preferred.
- Direct experience in DC behavioral health or substance use disorder (SUD) billing strongly preferred.
- Familiarity with DC Department of Behavioral Health (DBH) certification standards, Medicaid billing requirements, and 42 CFR Part 2 confidentiality regulations.
Responsibilities
- Prepares, reviews, and submits accurate claims for SUD and behavioral health services to Medicaid, Medicare, and third-party payers using eClinicalWorks (eCW).
- Verifies client Medicaid, Medicare, and third-party insurance eligibility, and confirms authorization requirements prior to and during treatment.
- Posts payments, adjustments, and denials accurately and in a timely manner, and reconciles accounts receivable within eCW.
- Identifies, researches, and resolves claim denials and rejections, including timely resubmission or appeal of denied claims.
- Monitors claims audit error rates and works to keep them within Department of Behavioral Health (DBH) certification standards.
- Coordinates with clinical staff to ensure documentation supports billed services and complies with DBH, Medicaid, and other payer requirements.
- Generates and reviews billing reports, aging reports, and revenue cycle metrics for leadership, identifying trends and areas for improvement.
- Maintains compliance with 42 CFR Part 2, HIPAA, and other Federal and District confidentiality regulations when handling client billing information.
- Works closely with the finance and clinical teams to support accurate revenue reporting and resolve billing-related client or provider inquiries.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
