Lead Billing Specialist

Behavioral Framework – the leading provider of ABA therapy to children diagnosed with autism in the DMV area – is looking for a Lead Billing Specialist.

The Lead Billing Specialist serves as the subject matter expert for all aspects of insurance billing related to ABA therapy services. This role is responsible for managing complex billing tasks, supporting resolution of escalated issues, and ensuring claims are submitted and processed accurately. The Lead Billing Specialist supports the Department Manager by serving as a go-to resource for the billing team and helping drive efficiency, accuracy, and consistency in billing processes.

Behavioral Framework Highlights:

• Behavioral Framework is devoted to the pursuit of providing excellent, honest, and compassionate care within the autism community.

• We believe in the dedication and passion of our professional team and the science behind ABA to make a difference in the families and children we serve.

• Ranked on the Inc. 5000 list for 3 consecutive years.

• 1 of 4 Autism providers in the country to earn 3-year accreditation telehealth from the Behavioral Health Center of Excellence

• Beautiful new office 2 minutes from I-270

Essential Functions

• Take ownership of complex claim issues, including high-dollar or aged claims, appeals, and payer-specific challenges.

• Ensure proper submission of claims in accordance with payer requirements.

• Conduct deep dives into denial trends and recommend process improvements to reduce future denials.

• Perform thorough payment reconciliations and resolve discrepancies with insurance companies.

• Serve as a knowledge resource for the billing team, helping troubleshoot issues and answer questions related to billing processes, payer rules, and system usage.

• Assist the Billing Manager with training new team members or introducing process updates.

• Collaborate closely with intake, authorizations, and client services to support timely and accurate billing.

Knowledge, Skills, Experience

• Maintain confidentiality; adhere to all HIPAA guidelines/regulations.

• Knowledge of the behavioral health industry and terms.

• 3 year experience with medical billing and claims processing.

• Experience working with insurance companies.

• Knowledge of regulations related to Medicaid and commercial insurance.

• Excellent attention to detail and accuracy in entering financial data.

• Excellent organizational skills, deadline-driven with excellent time management ability.

• Outstanding math and research skills.

• Proficiency in Microsoft Office Suite.

• Working knowledge of Practice Management Systems

• Min High School diploma, college degree preferred

Work Environment, Physical Conditions

• Ability to work in a fast-paced environment.

• Ability to work 40 hours per week.

• Ability to work cooperatively with others.

• Must comply with practice policies and procedures.

• Requires daily in-office work. Does not meet the requirements of regular telecommuting.

• Physical activities include sitting for long periods of time, walking, bending, kneeling.

• Must be able to reach, pull, and push.

• Requires manual dexterity, auditory and visual skills.

• Ability to lift up to 15 lbs.

EOE

Behavioral Framework is committed to equitable treatment for all employees, clients, and their families. We welcome and respect the diversity of the families we serve, and we focus our organizational efforts to build a culture of respect, dignity, fairness, caring, equality, and self-esteem.

We believe our strength comes from the shared experiences of our employees, clients, and community. We pride ourselves on serving a diverse population and always seeking to hire, retain, and promote from a wide variety of backgrounds.

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