Medicaid Billing Specialist — Behavioral Health (Hybrid Seattle)

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

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