Medical Billing Specialist Behavioral Health – Virginia Medicaid (DMAS / ARTS) Location: Remote or Virginia-Based Preferred Employment Type: Full-Time Compensation: Competitive, based on experience

Position Overview

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

Required Qualifications

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

Preferred Qualifications

Experience in DBHDS-licensed programs

Knowledge of Virginia regulatory billing requirements

Experience with claim auditing and compliance review

Core Competencies

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.