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

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 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.

• 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

• 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

• 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 under payers for escalation

• 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)

• 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)

• 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…