Senior Billing Specialist

Senior Billing Specialist

Department: Operations
Employment Type: Full Time, 40 hours/week
Location: Hybrid - Lewes and Milton, DE (2 days/week on-site, 3 days remote)
Minimum Experience: 5+ years medical billing experience
Compensation: $58,000 to $62,000 annually

About Trauma Specialists

Trauma Specialists is a values-based community of helping professionals working to provide effective, evidence-based trauma treatment to enhance the mental well-being of children, adults, families, and couples in our communities across Maryland, Delaware, and Pennsylvania. We are a highly skilled, dynamic, and collaborative team committed to treating the impact of trauma through specialized care grounded in clinical rigor and cultural humility.

Our mission extends beyond clinical excellence-we're building a practice where healing begins with restoring one's relationship with Self and expands to healthier relationships with Others and with Nature. Behind every therapy session is a dedicated operations team ensuring our clinicians can focus on what matters most: transforming lives.

The Role

The Senior Billing Specialist is the operational backbone of our revenue cycle-responsible for converting completed therapy sessions into timely cash collection while maintaining the financial health that enables us to serve our communities. This role combines hands-on billing execution with analytical problem-solving, process systematization, and quality control.

You'll own billing operations end-to-end with autonomy to identify problems, build solutions, and drive measurable cash flow outcomes. We are seeking someone who gets satisfaction from fixing broken processes, catching money left on the table, and seeing direct results from your work.

You'll work hybrid from our Lewes and Milton, DE location (typically 2 days/week on-site, 3 days remote), giving you concentrated time for collaboration on-site and deep-focus billing work from home.

What You'll Do

Daily Billing Operations

Claims & Collections Management

• Submit clean claims within 48 hours of service delivery, maintaining ≥95% clean claim rate
• Post insurance payments daily and reconcile against contracted rates to catch underpayments
• Work AR aging aggressively-prioritize claims >30 days with systematic payer follow-up
• Research and resolve denials within 5 business days, identifying root causes to prevent recurrence
• Achieve 90%+ collection rate through proactive insurance follow-up and client billing
• Handle client billing inquiries with empathy, explaining insurance processing and payment responsibilities clearly

Payer Relations & Problem-Solving

• Call insurance companies, navigate payer portals, and resolve claim holds or pending statuses
• Appeal underpayments and incorrect denials-advocate for proper reimbursement
• Build working relationships with payer representatives to resolve issues efficiently
• Troubleshoot complex billing scenarios independently

Analytical & Process Management (Systems Building)

Payment Accuracy & Rate Protection

• Maintain fee schedule reference documents by payer and CPT code
• Compare ERAs to contracted rates monthly-catch and recover underpayments
• Track payer payment accuracy trends and flag chronic underpayers for escalation

Process Documentation & Standardization

• Create and maintain billing SOPs: claim submission workflows, denial resolution protocols, payment posting procedures
• Build checklists for recurring tasks to ensure consistency
• Document payer-specific rules (modifiers, telehealth policies, authorization requirements)

Quality Control & Compliance

• Conduct monthly internal audits: review 15-20 claims for coding accuracy, modifier usage, authorization compliance
• Review clinician documentation for billing red flags and provide constructive feedback
• Track audit pass rate (target: ≥95% error-free)

Reporting & Performance Tracking

• Weekly reporting: claims submitted, cash collected, denials/rejections
• Monthly reporting: total outstanding balance, insurance AR aging, client AR aging, unallocated payments
• Monthly analysis: identify trends, bottlenecks, and root causes of cash flow problems
• Propose specific solutions with clear business impact
• Flag emerging risks to leadership proactively

Credentialing Management

Provider Enrollment & Maintenance

• Submit credentialing applications for new clinicians within 5 days of hire
• Maintain CAQH profiles for all credentialed clinicians (re-attest every 90 days)
• Track application status with weekly follow-ups-get clinicians billing-ready within 90 days
• Record effective billing dates and communicate status to leadership
• Pull annual fee schedules and support rate re-negotiation efforts

Team Coordination

Clinician Collaboration

• Work directly with therapists to resolve documentation issues blocking claims
• Provide feedback on note timeliness and completeness
• Communicate payer-specific requirements (authorization needs, session limits)

Leadership Communication

• Weekly metric updates via dashboard
• Recommend solutions with clear rationale
• Escalate complex payer issues or compliance concerns

Location Operations Support

As a small practice, we value team members who can contribute beyond a single function. This role includes light administrative support for our Delaware locations (~2-5 hours/week), helping ensure our sites run smoothly so clinicians can focus on client care.

Facility & Operations

• Maintain office supplies and inventory (ordering, restocking, organizing)
• Serve as point of contact for building maintenance issues (coordinate with vendors, facilities)
• Troubleshoot basic facility issues (Wi-Fi, printers, climate control)

Team Support

• Welcome and orient new staff to Delaware office locations
• Help coordinate team events and gatherings
• Support onboarding logistics (office access, supplies, facility walkthrough)

This work happens on-site during your 2 days/week in Lewes and takes roughly an hour per on-site day. It's the reality of working in a smaller practice environment where everyone pitches in to support the team.

What You Bring

Required Qualifications

• 5+ years hands-on medical billing experience, preferably in mental health, behavioral health, or outpatient therapy settings
• Strong insurance billing expertise: Deep working knowledge of claim submission, ERA/EOB interpretation, denial resolution, appeals, authorization requirements, and payer relations
• Payment reconciliation experience: Track record of comparing payments to contracted rates and catching underpayments
• Data analysis skills: Proficient with Excel/Google Sheets (formulas, pivot tables, data manipulation) and able to export, organize, and analyze billing data to identify trends and reconcile payments
• Practice management systems proficiency: Comfortable learning new software quickly (SimplePractice experience a plus)
• Analytical problem-solving: Can look at reports, spot patterns, diagnose root causes, and propose practical solutions
• Process orientation: Has created SOPs, workflows, checklists, or training materials that others successfully used
• Attention to detail: Catches coding errors, payment discrepancies, and process breakdowns that others miss
• Communication skills: Can explain complex billing issues clearly to clinicians, clients, and leadership
• Self-directed work style: Comfortable managing own workload with accountability for measurable outcomes
• Conflict comfort: Willing to have direct conversations when documentation isn't supporting claims, when payers are underpaying, or when processes aren't working

Preferred Qualifications

• Experience with multi-state billing (MD, DE, PA)
• Certified Professional Biller (CPB), Certified Professional Coder (CPC), or similar credential
• Background in smaller practices where you've had to figure things out independently and wear multiple hats
• Track record of improving collection rates, reducing AR aging, or implementing process improvements in a previous role
• Knowledge of trauma therapy billing specifics (EMDR, intensive therapy models, group therapy)

What We Offer

Compensation & Benefits

• Salary: $58,000-$62,000 annually (based on experience and demonstrated qualifications)
• Full benefits package: Medical, dental, vision, short-term/long-term disability, and life insurance
• 401(k) with employer match
• Bi-monthly wellness stipend
• Discounted pet insurance
• Paid time off: Vacation, sick leave, and holidays

Work Structure & Flexibility

• Hybrid schedule: 2 days/week on-site in Lewes and Milton, DE; 3 days remote
• Remote-friendly: Deep-focus billing work from home
• Professional growth: Autonomy to build systems, implement improvements, and directly impact practice sustainability

Our Culture & Values

This role requires Courage in Action-the willingness to have direct conversations when documentation isn't supporting claims, when payers are underpaying, or when processes aren't working. We need someone who is Relational & Collaborative while maintaining Excellence in Execution through consistent follow-through and accountability for results.

People First means treating clients with respect when they're confused about billing, and treating clinicians as partners in ensuring their documentation supports their work getting paid. We believe people do their best work when they feel supported-and when they know their contributions directly impact our ability to serve clients experiencing trauma. Wholeness means we create space for you to bring your full self to work and maintain sustainable work-life integration -- both professional fulfillment and personal wellbeing working together.

We're a values-based community where your work directly enables life-changing trauma treatment in Maryland, Delaware, and Pennsylvania. You'll be part of a dynamic, collaborative team committed to clinical excellence and operational integrity.

Ready to Apply?

If you're a billing professional who takes pride in clean claims, accurate payments, and efficient operations-and wants your expertise to directly enable trauma healing in your community-we'd love to hear from you.

To Apply: Please submit your resume and a brief cover letter addressing:

1. Your experience with payment reconciliation and catching payer underpayments
2. An example of a process improvement or system you implemented in a previous billing role
3. Your approach to working independently while maintaining accountability for outcomes

We're looking for someone who can start making an impact within 30 days. This role is critical to practice sustainability and we're prepared to move quickly for the right candidate.

Trauma Specialists is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment where people of all identities feel respected, heard, and safe to be themselves.