Medicaid Billing & Revenue Cycle Specialist

Reports to: Director of Revenue Cycle Direct Reports: none About Us God Restoring Order (GRO) Community is a mental healthcare provider that specializes in trauma recovery services for males of color ages 5 and up. GRO services are grounded in an understanding of the neurological, biological and psychological effects of trauma. GRO services include mental health and wellness, stress management, and community outreach. Position Summary The Revenue Biller is responsible for managing and processing Medicaid and third-party insurance claims for services delivered across Illinois and Ohio operations. This role ensures accurate coding, timely submission, reimbursement tracking, and resolution of claim discrepancies to support optimal revenue cycle performance. The Revenue Biller plays a critical role in maintaining compliance with state Medicaid regulations, improving reimbursement efficiency, and safeguarding organizational revenue integrity. Key Responsibilities Collect and process Ohio and Illinois Medicaid reimbursements by gathering, coding, and transmitting client service information accurately and timely. Review client records to verify proper Medicaid coding, service authorization, and documentation completeness. Submit electronic claims through designated Medicaid portals and billing platforms. Verify accuracy of Medicaid coding prior to submission to ensure payment integrity. Monitor claim status and ensure timely adjudication within standard processing periods. Claim Resolution & Follow-Up Investigate and resolve billing discrepancies through detailed research and data analysis. Adjust patient bills based on remittance advice and Medicaid correspondence. Resolve denied or disputed claims by consulting with Medicaid claims representatives and providing additional documentation as required. Follow up on unpaid or delayed claims within standard claim aging timelines. Maintain detailed documentation of claim follow-up and resolution efforts. Revenue Integrity & Reporting Analyze billing records for completeness and accuracy; obtain clarifications when needed. Prepare Monthly Reports Summarizing Medicaid billings submitted Adjustments and write-offs Payments received Track reimbursement trends and flag revenue risks to leadership. Assist in internal audits related to Medicaid billing compliance. Insurance & Third-Party Billing Collect and bill commercial insurance carriers and other third-party payers as applicable. Verify eligibility and coverage prior to billing. Ensure coordination of benefits when multiple payers are involved. Compliance & Professional Development Stay current on Illinois and Ohio Medicaid billing regulations, coding updates, and professional development opportunities related to Medicaid billing. Maintain confidentiality and compliance with HIPAA and organizational standards. Revenue integrity mindset Regulatory compliance awareness Analytical problem-solving Detail orientation Accountability & follow-through Multi-state operational knowledge Work Setting Onsite Office Setting May require coordination with multi-state teams Standard business hours with occasional deadline-driven demands Qualifications Bachelor's degree in Healthcare Administration, Business, Finance, or related field required. Experience Minimum 2–3 years of Medicaid billing experience (Illinois and/or Ohio preferred). Experience working in behavioral health, community mental health, or social services. Billing experience strongly preferred. Experience with electronic health record (EHR) systems and Medicaid portals required. What We Offer Competitive salary and benefits package. A supportive and dynamic work environment committed to social impact. Opportunities for professional development and growth. How to Apply At GRO Community, we believe in healing through empowerment and innovation. Our work centers on serving individuals and families with compassion and integrity. Join our team to make a meaningful impact while building your professional skills in a supportive and mission-driven environment. Interested candidates should submit a resume and cover letter detailing their relevant experience to View email address on click.appcast.io. #J-18808-Ljbffr GRO Community