Overview
We're seeking a Medicaid Billing Specialist with experience in Healthcare or Behavioral Health - Join our Mission-Driven Team!
Location: In-Office | Addison, TX (Near Beltline & Tollway)
Schedule: Full-Time | Monday–Friday
You're Role & What You'll Do:
The Medicaid Billing Specialist ensures proper submission and adjudication of all claims submitted to Medicaid carriers while working within the deadlines and protocols of the assignments. This position will focus primarily on reviewing and assessing Medicaid denials or returned claims. Must be able to communicate with all states Medicaid and MCO’s from a resolution-based perspective. This communication should be focused on acquired knowledge, insurance carrier guidelines, company policies & procedures, research, and collection efforts.
- Responsible for understanding all procedures within regulatory mandates.
- Initiating claims adjustments and resubmission of claims to Medicaid and MCO’s.
- Evaluates payments/denials received for correctness and ensures they are applied accordingly.
- Maintains contact with other departments to obtain patient or insurance information needed for claim payment.
- File and handle confidential documentation and patient health information (PHI); adhere and follow all HIPAA mandated guidelines.
- Maintains a broad range of knowledge of insurance plans, medical terminology, billing procedures, government regulations, and medical codes.
- Analyze and evaluate Medicaid claim payments using the company's systems and tools. Use payment documentation provided by payers to determine if the medical provider has been reimbursed in compliance with the applicable state fee schedule.
- Ensures that the activities of the collection operations are conducted in a manner that is consistent with overall department protocol, and are following Federal, State, and payer regulation, guidelines, and requirements.
- Conduct timely and thorough telephone follow-up with Medicaid to ensure claims with supporting documentation have been received and facilitate prompt reimbursement.
- Assist in efficiently moving work through the department, working as part of a team. Identifying and investigating Medicaid claims issues to resolution/payment.
- Follows up on claims submitted to ensure carrier has received into adjudication for the receipt of prompt and timely payment. Escalates issues, as necessary.
- Identifies bad debt write-offs and A/R adjustments. Initiates write-offs and adjustments in accordance with policies and procedures.
- Strong interpersonal and communication skills with an ability to work effectively with teams, managers, and executive staff.
- Verifies billing accounts with accounts receivable ledger to ensure that all payments are accounted for and properly posted.
- Documents, in detail, phone calls, phone number, person spoken to, and call details on a consistent basis.
- Identifies any overpayments and/or duplicate payments and investigates and resolves accordingly.
- Send secondary claims as soon as primary remit is received to avoid delays with payment.
- Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.
- Resolves issues that created a denial within 3 days of receipt of denial.
- Familiar with Electronic Medical Records and Billing Systems.
- Timely medical records request for Appeal Process.
- Reducing outstanding A/R and aging reports.
- Perform any other duties as assigned to support department goals.
Qualifications:
3–5 years of medical billing and collections experience required (Medicaid focus strongly preferred).
3–5 years Healthcare or behavioral health industry experience required.
Associates degree preferred (or equivalent work experience in lieu of degree).
Familiarity with medical coding, insurance plans, billing regulations, and Medicaid guidelines.
Excellent communication, organization, and problem-solving skills.
High attention to detail and a commitment to ethical and accurate billing practices.
Experience with Electronic Medical Records (EMR) and billing systems.
Team-oriented mindset and strong interpersonal skills.
Why choose Behavioral Innovations:
- Compensation: Hourly Rate
- Insurance: Medical, Vision, Dental, and Supplemental Insurance Policies.
- Wellbeing Program: Equipping you with tools to achieve your wellness goals.
- OVIA Health: A Women's Health App supporting you throughout the entire Parenthood Journey.
- Employee Assistance Program (EAP): Comprehensive support for your mental, emotional, and physical health.
- Daily Pay: Access your pay when you need it!
- University Partnerships: Enjoy tuition rate discounts.
- Supportive Team Structure: Our clients and families are our top priority, and we foster a collaborative and expert team environment.
- Family-Centric Culture – We foster a caring and collaborative work environment.
- Professional Growth – We invest in training, development, and career advancement opportunities.
- Recognition & Support – Your contributions matter, and we celebrate your achievements.
Award-Winning Culture – Honored with the Clinical Excellence Award in 2021 for our commitment to ethical standards and compassionate care.
Recognized Industry Leader – Named Company of the Year in 2022, reflecting our continued growth and impact in the ABA field.
National Recognition – Proudly ranked on the Inc. 5000 list as one of America’s Fastest Growing Private Companies.
Mission-Driven Work – Dedicated to transforming the lives of children with autism through high-quality, center-based ABA therapy.
Values-Driven Organization – Guided daily by our Core Values, with integrity at the heart of everything we do.
Team Unity & Trust – Achievements are made possible by a collaborative, purpose-driven team and strong partnerships
About Behavioral Innovations:
Celebrating 25 Years of Service: Behavioral Innovations is a leading provider committed to transforming lives by providing compassionate, center-based ABA therapy for children with autism, ages 18 months to 10 years. With over 90 locations across Texas, Oklahoma, and Colorado—and upcoming expansions into Virginia and Maryland—we’re growing rapidly. Join our dynamic team and use your expertise to streamline processes and strengthen the financial health of our organization, enabling us to stay focused on what matters most: making a meaningful difference in the lives of the families we serve.
Ready to Make an Impact?
Are you passionate about accuracy, driven by process, and experienced in Medicaid billing within the healthcare or behavioral health space?
Apply Today! Join Behavioral Innovations, a leading provider of center-based ABA therapy, and help transform lives by ensuring our financial operations support our clinical mission.
CORP2025
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