Behavioral Health Medicaid Billing Specialist Company:

Foundation X Position:

Behavioral Health Medicaid Billing Specialist Job Type:

Full-Time Work Setting:

Remote Industry:

Behavioral Health / Mental Health Services Position Summary (Contract Position 1099) Foundation X is seeking an experienced Behavioral Health Medicaid Billing Specialist to manage Medicaid billing, claims follow-up, MCO communications, provider roster maintenance, and related billing functions. We are specifically seeking someone who has hands-on experience billing Louisiana Medicaid Managed Care Organizations (MCOs) and understands the billing and reimbursement process within a behavioral health setting. This is not an entry-level billing position . The ideal candidate should be able to independently work claims, identify billing problems, communicate with MCOs, maintain provider rosters, and help ensure claims are processed and paid correctly. Primary Responsibilities The Billing Specialist will be responsible for: Preparing, reviewing, and submitting Medicaid behavioral health claims. Working directly with Medicaid Managed Care Organizations (MCOs) regarding claims, denials, payment issues, provider enrollment, and billing concerns. Uploading and maintaining staff/providers on MCO rosters. Verifying that newly hired providers are properly added to applicable MCO rosters before services are billed. Monitoring provider roster status and correcting roster discrepancies that may cause claims to deny. Reviewing claims for accuracy before submission. Working rejected, denied, or unpaid claims and completing necessary corrections or resubmissions. Following up on outstanding accounts receivable and aging claims. Researching underpayments, nonpayments, and claim-processing issues. Reviewing EOBs/remittance information and identifying trends in denials. Communicating with MCO provider relations and claims departments to resolve payment issues. Maintaining documentation of calls, reference numbers, disputes, reconsiderations, and claim follow-up. Assisting with claim reconsiderations, appeals, and corrected claims when necessary. Monitoring billing deadlines and timely-filing requirements. Verifying that billing information matches staff credentials, services rendered, authorizations, and payer requirements. Identifying billing or documentation issues that could delay reimbursement and communicating those issues to management. Producing billing, payment, denial, and accounts-receivable reports for management. Working collaboratively with administrative, clinical, and management staff to resolve billing issues.

Required Experience Applicants should have:

Previous Medicaid billing experience . Previous behavioral health or mental health billing experience . Experience working directly with Medicaid Managed Care Organizations (MCOs) . Experience adding, uploading, and maintaining providers/staff on MCO rosters . Experience researching and correcting denied or rejected Medicaid claims. Knowledge of claims submission, remittance, denials, reconsiderations, appeals, and timely filing. Experience communicating directly with MCO provider relations and claims representatives. Strong understanding of accounts receivable and claims follow-up. Strong attention to detail and ability to identify billing discrepancies. Preferred Experience Checkpoint EHR experience is strongly preferred. Experience billing Louisiana Medicaid behavioral health services. Familiarity with behavioral health

CPT/HCPCS

codes and Medicaid billing requirements. Experience with services such as CPST, PSR, Crisis, or other Medicaid-funded behavioral health programs. Experience working with multiple Medicaid MCO portals. Experience preparing aging reports and monitoring outstanding A/R. Qualifications Minimum 2 years of medical or behavioral health billing experience preferred. Ability to work independently in a remote environment. Strong organizational and problem-solving skills. Excellent written and verbal communication skills. Ability to manage multiple payer issues simultaneously. Ability to maintain confidentiality and comply with HIPAA requirements. Comfortable communicating with MCO representatives to aggressively but professionally resolve unpaid or incorrectly processed claims. Ideal Candidate The ideal candidate is someone who can come into the position with minimal billing training and already understands Medicaid managed-care billing. We are looking for someone who knows how to investigate a claim from beginning to end—not simply submit claims. The successful candidate should be comfortable identifying why a claim did not pay, determining what needs to be corrected, contacting the MCO when necessary, documenting the resolution, and following the claim until payment is received. Checkpoint EHR experience is a major plus, but candidates with strong Medicaid behavioral health billing and MCO roster experience are encouraged to apply.

Pay:

$18.00 - $25.00 per hour Expected hours: 30.0 per week

Benefits:

Flexible schedule

Experience:

Medical billing: 2 years (Required)

Work Location:

Hybrid remote in Baton Rouge, LA 70816