Medical Biller
Alexandria, Fairfax County, Virginia, 22350, USA
Listed on 2026-03-03
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Healthcare
Medical Billing and Coding, Healthcare Administration
Medical Billing Specialist Behavioral Health – Virginia Medicaid (DMAS / ARTS)
Location:
Remote or Virginia-Based Preferred
Employment Type:
Full-Time Compensation:
Competitive, based on experience
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.
Key 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
- 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
This position is ideal for a billing professional who understands the complexities of Virginia Medicaid behavioral health billing and can contribute to maintaining compliance, reducing denials, and improving revenue cycle performance.
This is a remote position.
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