Medicaid Billing Specialist for Behavioral Health

DeCoach Recovery Centre is a leading addiction treatment center with offices throughout southwest Ohio.  We are currently hiring a Medicaid Billing Specialist to work out of our Sharonville Headquarters. The Medicaid Billing Specialist plays a critical role in ensuring accurate and timely submission of Medicaid claims to maximize reimbursement for behavioral health services provided. This position requires a deep understanding of Medicaid billing regulations, coding standards, and payer requirements to minimize claim denials and delays. The specialist will collaborate closely with healthcare providers, insurance companies, and internal billing teams to resolve discrepancies and optimize billing processes. By maintaining meticulous records and staying current with changes in Medicaid policies, the specialist helps sustain the financial health of the organization. Ultimately, this role contributes to the efficient revenue cycle management and supports the delivery of quality healthcare services to Medicaid beneficiaries.

Minimum Qualifications:

• High school diploma or equivalent; associate degree or higher in healthcare administration or related field preferred.
• Minimum of 2 years experience in medical billing, specifically with Medicaid claims.
• Strong knowledge of Medicaid billing regulations, CPT, ICD-10, and HCPCS coding systems.
• Proficiency with electronic health record (EHR) systems and medical billing software.
• Excellent attention to detail and organizational skills.

Preferred Qualifications:

• Certification as a Certified Professional Biller (CPB) or Certified Coding Specialist (CCS).
• Experience working in a healthcare setting such as hospitals, clinics, or social assistance organizations.
• Familiarity with state-specific Medicaid programs and policies.
• Advanced proficiency in billing software such as Epic, Cerner, or Medisoft.
• Strong analytical skills and experience with billing data analysis tools.

Responsibilities:

• Prepare, review, and submit Medicaid claims accurately and in compliance with federal and state regulations.
• Verify patient eligibility and coverage details prior to billing to reduce claim rejections.
• Monitor claim status and follow up on unpaid or denied claims to ensure timely resolution.
• Collaborate with healthcare providers and coding specialists to ensure correct procedure and diagnosis codes are used.
• Maintain up-to-date knowledge of Medicaid billing policies, coding changes, and payer requirements.
• Generate reports on billing activities, claim denials, and reimbursement trends to identify areas for improvement.
• Assist in training staff on Medicaid billing procedures and compliance standards.
• Communicate effectively with Medicaid representatives and other insurance entities to resolve billing issues.

Benefits:

• Medical, Dental and Vision Insurance Plans
• Tuition Reimbursement 
• Company Paid Life Insurance Policy
• Company Matched 401(k) plan
• Paid Holidays and PTO plan
• Opportunities for Advancement 
• Yearly Merit Raises 
• STAR Eligible Facilities