Medicaid Billing Specialist

Plymouth Housing Group; Washington (District of Columbia); Hybrid; USD 44,000 - 51,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

PTO

403(b) retirement plan

Employee Assistance Program

ORCA pass subsidy

Full-time benefits

Job summary

Plymouth Housing is seeking a Medicaid Billing Specialist to manage billing activities for behavioral health services, ensuring accurate, timely, and compliant reimbursement. This role supports Medicaid eligibility verification, claims submission, payment posting, accounts receivable reconciliation, and reimbursement tracking in collaboration with program staff and managed care organizations.

A detail-oriented professional with knowledge of Medicaid billing practices is required to protect

Qualifications

• Builds trust and works respectfully with people from many backgrounds.
• Uses self-awareness to communicate effectively across differences, adapt approach, and treat people with fairness and respect.
• Demonstrates accuracy, attention to detail, and sound judgment when reviewing claims, documentation, payments, and financial records.
• Applies knowledge of Medicaid billing guidelines, claim-submission processes, reimbursement requirements, and behavioral health billing practices.
• Investigates denials, payment discrepancies, documentation gaps, and unpaid claims using strong analytical and problem-solving skills.
• Manages competing priorities, deadlines, and high-volume billing activity with strong organization and follow-through.
• Communicates clearly and professionally with program staff, administrative staff, Medicaid representatives, managed care organizations, and other partners.
• Maintains confidentiality and handles sensitive client, health, and financial information appropriately.
• Demonstrates a compliance-focused mindset and commitment to accurate, ethical, and timely billing practices.
• Works effectively both independently and collaboratively using electronic health records, billing software, and related reporting tools.

Responsibilities

• Prepare, review, and submit accurate and timely Medicaid claims for behavioral health services.
• Verify client Medicaid eligibility, authorizations, service coverage, documentation, and other billing requirements before submitting claims.
• Monitor claim status and resolve rejected, denied, unpaid, incomplete, or otherwise delayed claims, including follow-up and appeals with Medicaid and managed care organizations.
• Post Medicaid payments, adjustments, and other account activity accurately and promptly.
• Reconcile accounts receivable, investigate payment variances and discrepancies, track reimbursement activity, and follow up on outstanding balances.
• Communicate with program and administrative staff to resolve missing, incomplete, or inconsistent documentation.
• Maintain accurate claim, billing, payment, financial, and supporting records in accordance with organizational and regulatory requirements.
• Support compliance with federal and Washington State Medicaid requirements, behavioral health billing standards, managed care requirements, and reimbursement procedures.
• Assist with internal and external audits by providing accurate records and supporting documentation.
• Generate and analyze billing, claims, accounts receivable, and revenue reports to identify trends, errors, and opportunities to improve accuracy, timeliness, compliance, and collections.
• Stay informed about applicable Medicaid policy changes, billing codes, claims procedures, and reimbursement requirements.

Skills

Attention to detail

Analytical skills

Communication

Confidentiality

Compliance

Time management

Education

High school diploma or equivalent

Associate’s or bachelor’s degree in healthcare administration, business, finance, medical billing and coding, or a related field

Medical billing or coding certification

Tools

Electronic health records (EHR)

Billing software

Reporting tools

Job description

Job Description

SALARY$32.62 - $37.49 per hourNew hires may earn a salary ranging from the minimum to the midpoint of the pay scale, with education and experience taken into consideration.

BENEFITSWe offer a comprehensive benefits package for Full-Time employees, including Medical, Dental, Vision, PTO, and 403(b) options. Additionally, employees have access to supplementary benefits such as the Employee Assistance Program, a subsidized ORCA pass, and more. This is a full-time position with benefits.

LOCATIONSeattle, WA (Hybrid)

JOIN OUR MISSION TO END HOMELESSNESS

Plymouth Housing is a nonprofit organization that develops and operates permanent supportive housing for single adults who have experienced chronic homelessness. With apartment buildings throughout King County, we believe everyone deserves a safe home and the opportunity to thrive. That’s why we provide long-term housing paired with on-site services that promote stability, health, and community. Our culture is rooted in dignity, respect, and shared responsibility: We practice hospitality, communicate with care, and collaborate across differences. We value lived experience, cultural responsiveness, and approaches grounded in harm reduction, trauma-informed practice, and resident choice. We look for people who are committed to safety, learning, and continuous improvement — and who bring steady, values-aligned service in moments that are complex or high-stress.

ABOUT THIS ROLE

The Medicaid Billing Specialist manages billing activities for behavioral health services, helping ensure accurate, timely, and compliant reimbursement. This role supports Medicaid eligibility verification, claims submission, payment posting, accounts receivable reconciliation, reimbursement tracking, denial management, and billing-related reporting.The Medicaid Billing Specialist partners with program and administrative staff, Medicaid representatives, and managed care organizations to resolve documentation and claims issues. This position is well suited for a detail-oriented professional who understands healthcare or behavioral health billing, protects confidential information, and can manage multiple deadlines in a collaborative environment.

PRIMARY RESPONSIBILITIES

• Prepare, review, and submit accurate and timely Medicaid claims for behavioral health services.
• Verify client Medicaid eligibility, authorizations, service coverage, documentation, and other billing requirements before submitting claims.
• Monitor claim status and resolve rejected, denied, unpaid, incomplete, or otherwise delayed claims, including follow-up and appeals with Medicaid and managed care organizations.
• Post Medicaid payments, adjustments, and other account activity accurately and promptly.
• Reconcile accounts receivable, investigate payment variances and discrepancies, track reimbursement activity, and follow up on outstanding balances.
• Communicate with program and administrative staff to resolve missing, incomplete, or inconsistent documentation.
• Maintain accurate claim, billing, payment, financial, and supporting records in accordance with organizational and regulatory requirements.
• Support compliance with federal and Washington State Medicaid requirements, behavioral health billing standards, managed care requirements, and reimbursement procedures.
• Assist with internal and external audits by providing accurate records and supporting documentation.
• Generate and analyze billing, claims, accounts receivable, and revenue reports to identify trends, errors, and opportunities to improve accuracy, timeliness, compliance, and collections.
• Stay informed about applicable Medicaid policy changes, billing codes, claims procedures, and reimbursement requirements.

KNOWLEDGE, SKILLS, AND ATTRIBUTES WE NEED FROM YOU

• Builds trust and works respectfully with people from many backgrounds and lived experiences, contributing to safe, welcoming housing communities where residents experience dignity, choice, and belonging.
• Uses self-awareness to communicate effectively across differences, adapt approach, and treat people with fairness and respect.
• Demonstrates accuracy, attention to detail, and sound judgment when reviewing claims, documentation, payments, and financial records.
• Applies knowledge of Medicaid billing guidelines, claim-submission processes, reimbursement requirements, and behavioral health billing practices.
• Investigates denials, payment discrepancies, documentation gaps, and unpaid claims using strong analytical and problem-solving skills.
• Manages competing priorities, deadlines, and high-volume billing activity with strong organization and follow-through.
• Communicates clearly and professionally with program staff, administrative staff, Medicaid representatives, managed care organizations, and other partners.
• Maintains confidentiality and handles sensitive client, health, and financial information appropriately.
• Demonstrates a compliance-focused mindset and commitment to accurate, ethical, and timely billing practices.
• Works effectively both independently and collaboratively using electronic health records, billing software, and related reporting tools.

QUALIFICATIONS

• High school diploma or equivalent required.
• At least two years of Medicaid billing experience, preferably in behavioral health or healthcare.
• Experience preparing and submitting Medicaid claims and resolving rejected, denied, unpaid, or incomplete claims.
• Experience with payment posting, accounts receivable tracking, reimbursement follow-up, or financial reconciliation.
• Familiarity with electronic health records and medical billing software.
• Familiarity with Washington State Medicaid policies and managed care plans preferred.
• Associate’s or bachelor’s degree in healthcare administration, business, finance, medical billing and coding, or a related field preferred.
• Medical billing or coding certification preferred.

Plymouth Housing is an equal opportunity employer. We recruit, hire, train, and promote employees based on merit and business needs, and without regard to race, color, creed, religion, national origin, ancestry, citizenship or immigration status, sex (including pregnancy, gender identity, and sexual orientation), age, marital status, physical, sensory, or mental disability, honorably discharged veteran or military status, or any other status protected by applicable federal, state, or local law.