Medical Biller

Revive Bhs Llc

2d•Remote

About The Position

We are seeking a detail-oriented Medical Billing Specialist with direct experience in Virginia Medicaid (DMAS) behavioral health billing. The ideal candidate will have hands-on experience submitting and managing claims for ARTS programs and other behavioral health services, and will understand documentation requirements, authorizations, and denial management within Virginia Medicaid and MCO systems.

Requirements

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
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

Nice To Haves

Experience in DBHDS-licensed programs
Knowledge of Virginia regulatory billing requirements
Experience with claim auditing and compliance review

Responsibilities

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