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
Build working relationships with payer representatives to resolve issues efficiently
Conduct monthly internal audits: review 15-20 claims for coding accuracy, modifier usage, authorization compliance
Track audit pass rate (target: ≥95% error-free)

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

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
Hybrid schedule: 2 days/week on-site in Lewes and Milton, DE; 3 days remote

Senior Billing Specialist

Key skills