Senior Billing Specialist

Trauma Specialists of Maryland•Milton, DE

3d•$58,000 - $62,000•Hybrid

About The Position

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. 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.

Requirements

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

Nice To Haves

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)

Responsibilities

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 underpayers 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 proactively
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
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)
Weekly metric updates via dashboard
Recommend solutions with clear rationale
Escalate complex payer issues or compliance concerns
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)
Welcome and orient new staff to Delaware office locations
Help coordinate team events and gatherings
Support onboarding logistics (office access, supplies, facility walkthrough)