Medicaid Billing Specialist — Behavioral Health Claims Expert

Plymouth-Housing-Group; Seattle (WA); Hybrid; USD 45,000 - 52,000; Full time

Benefits offered by this job

Medical, Dental, Vision benefits

PTO

403(b) options

ORCA pass subsidy

Full-time with benefits

Job summary

Plymouth Housing in Seattle, WA seeks a Medicaid Billing Specialist to manage billing activities for behavioral health services, ensuring accurate, timely, and compliant reimbursement.

You will verify Medicaid eligibility, submit claims, post payments, reconcile accounts, track denials, and generate reports while maintaining confidentiality and adhering to Medicaid policies. This is a full-time role with a strong benefits package and community impact.

Qualifications

• Two years Medicaid billing experience, preferably in behavioral health.
• Experience submitting Medicaid claims and resolving denials.
• Experience with payment posting and accounts receivable tracking.
• Familiarity with EHR and medical billing software.
• Knowledge of Washington State Medicaid policies; preferred.

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 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 thinking

Communication

Organizational skills

Problem solving

Confidentiality

Compliance mindset

Independent work

Team collaboration

Medicaid billing knowledge

Education

High school diploma

Associate degree

Bachelor's degree

Medical billing/coding certification

Tools

Billing software

Electronic Health Records (EHR)

Reporting tools

Job description

Plymouth Housing in Seattle, WA seeks a Medicaid Billing Specialist to manage billing activities for behavioral health services, ensuring accurate, timely, and compliant reimbursement.

You will verify Medicaid eligibility, submit claims, post payments, reconcile accounts, track denials, and generate reports while maintaining confidentiality and adhering to Medicaid policies. This is a full-time role with a strong benefits package and community impact.