Reimbursement Lead

Reimbursement Lead

Salary

$70,921.50 - $125,014.50 Annually

Location

Prince William County, VA

Job Type

Full-Time (FT)

Job Number

202610893

Department

COMMUNITY SERVICES

Division

Administrative Services

Opening Date

10/23/2026

Closing Date

11/6/2026 11:59 PM Eastern

GRADE

C42

Hiring Salary

$70,921.50 - $97,968.00 Annually

• Description
• Benefits
• Questions

Introduction

Prince William County Community Services (CS) is seeking an experienced, collaborative, results-driven Reimbursement Team Lead to lead our Behavioral Healthcare Reimbursement team. We are a large, community-based behavioral health organization dedicated to providing high-quality services while ensuring accurate, timely, and compliant reimbursement for the care we provide.

This leadership position supervises reimbursement of professionals and will coordinate daily medical billing workflows, handle electronic payment imports into the Electronic Health Record (EHR), troubleshoot claims errors, and mentor staff to maximize revenue collection for Outpatient and Community Mental Health Rehabilitative services. The position plays a critical role in ensuring the integrity of the revenue cycle, maximizing reimbursement, maintaining regulatory compliance, and supporting the financial health of the organization.

About the Role

The Reimbursement Team Lead provides day-to-day leadership and oversight of the behavioral health revenue cycle, ensuring efficient billing operations, timely collections, and compliance with all federal, state, Medicaid, Medicare, Managed Care Organization (MCO), commercial insurance, and payer requirements.

Key responsibilities include:

• Supervise, mentor, coach, and provide technical guidance to a team of reimbursement professionals, assisting the Supervisor with workflow planning and staff training.
• Plan, prioritize, and assign staff work to ensure timely, accurate billing, reimbursement, and account collection activities.
• Oversee billing operations, including medical coding, charge entry, claims submission, payment posting, accounts receivable management, denial resolution, and reimbursement activities.
• Manage the daily import and reconciliation of electronic payments into the EHR, ensuring accurate posting and client account updates.
• Coordinate daily electronic payment workflows, including imports of 835s from clearinghouses and insurance portals, and direct electronic distribution for staff posting.
• Perform daily coding of electronic and mailed payments using the appropriate chart of accounts.
• Review unworked claim edits, rejections, and denials to resolve individual claim blocks and compile error details for supervisory review.
• Execute timely follow-up on aged receivables and unpaid services to reduce outstanding balances.
• Track the medical authorization process to ensure authorizations are requested and submitted within strict timely filing windows.
• Conduct deposit and transaction audits to maintain accurate internal accounting control records.
• Provide operational data and technical assistance to clinical staff, administrative personnel, and managers regarding billing metrics and documentation requirements.
• Ensure daily operations maintain strict compliance with state, federal, HIPAA, and DBHDS regulations.
• Monitor clearinghouse activity and insurance payer portals to identify claim issues, payment variances, and reimbursement opportunities.
• Review electronic payment distribution, claims submissions, and reimbursement activities to ensure accuracy, completeness, and timeliness.
• Analyze billing transactions, claims, and payment activity to ensure accurate coding, complete documentation, and timely reimbursement.
• Monitor billing matrix errors, denial trends, and unpaid services while collaborating with staff and program leadership to resolve recurring issues.
• Compile and analyze statistical and financial data.
• Complete monthly financial reconciliations between the EHR.
• Perform other duties as assigned.

The Successful Candidate Will Have

The ideal candidate is an experienced healthcare revenue cycle leader with strong knowledge of behavioral healthcare billing, Medicaid reimbursement, insurance claims management, and regulatory compliance. They possess exceptional analytical, organizational, and leadership skills and can build collaborative relationships with clinical staff, fiscal leadership, and external payer representatives.

If you are a collaborative leader who is passionate about improving revenue cycle performance, supporting staff development, and ensuring compliance in a behavioral healthcare environment, we encourage you to apply and become part of the Prince William County Community Services team.

Minimum Requirements: High school diploma or G.E.D. and 5 years of related experience in behavioral healthcare insurance billing, posting, collection, and revenue cycle.

Preferences:

• Experience supervising professional staff managing medical billing, accounts receivable, or healthcare reimbursement staff.
• Knowledge of behavioral healthcare billing, medical coding, revenue cycle, and insurance reimbursement processes.
• Knowledge of ICD-10 and CPT coding frameworks.
• Knowledge of Virginia Medicaid (DMAS) and Managed Care Organization (MCO) billing requirements.
• Experience working with Virginia Medicaid (DMAS), Managed Care Organizations (MCOs), Medicare, and commercial insurance billing requirements.
• Experience processing claims specifically for Behavioral Health, Substance Use, or Early Intervention environments.
• Hands-on experience using the Credible Electronic Health Record (EHR) platform or similar healthcare systems.
• Strong understanding of federal and state healthcare reimbursement regulations and compliance standards.
• Excellent analytical, problem-solving, organizational, and communication skills.
• Proficiency with Electronic Health Records (EHRs), clearinghouses, insurance portals, Microsoft Office applications, and financial reporting tools.
• The ability to manage multiple priorities while maintaining exceptional attention to detail and delivering outstanding customer service to both internal and external stakeholders.

Special Requirements (if applicable):

• Must possess a valid driver's license.

• Must pass DMV record check.

• Must pass TB test.

• Offer of employment is contingent upon the candidate passing a fingerprint-based national criminal history record check.

Child Protective Services Requirements: Effective 1999, mandated by the Virginia Department of Behavioral Health and Developmental Services (DBHDS) in accordance with 12VA35-105-400 rules and regulations for DBHDS Licensed Providers and related to the Criminal Registry Checks, a search of the registry of founded complaints of child abuse and neglect will be conducted by the Virginia Department of Social Services.

Work Schedule: The work hours will be Monday through Friday, 8:30 AM - 5:00 PM with a one-hour lunch. The position will be based out of one of two locations in Woodbridge, Virginia, and may be required to work one or two days a week at other Community Services work sites in Manassas or Woodbridge.

Hiring Salary Range: $70,921.50 - $97,968.00 Annually

We also offer great benefits, including:

• Retirement from the Virginia Retirement System (VRS)
• 401a and 457 retirement savings and investment plans
• Paid Annual Leave
• Paid Personal Leave
• Paid Sick Leave
• Paid Holidays
• Optional Group Medical and Dental Health Plans
• Optional Group Life Insurance
• An Employee Assistance Program (EAP)
• Career Development Opportunities

Full-time positions with Prince William County Government qualify for Public Service Loan Forgiveness. Click here for PSLF for additional information.

NOTE: The above position description is intended to represent only the key areas of responsibilities; specific position assignments will vary depending on the business needs of the department. To view the class description in its entirety, click here.

Prince William County is an Equal Opportunity Employer. In compliance with the Americans with Disabilities Act, the County will provide reasonable accommodations to qualified individuals with disabilities and encourages both prospective and current employees to discuss potential accommodations with the employer.

SEE YOURSELF HERE!

Prince William County Government offers medical plans with corresponding pharmacy and basic vision coverage, as well as dental plans and a separate vision plan.

Full-time and part-time Prince William County Government employees are eligible to participate in our plans; however, the level and cost of benefits depends on the classification of the position.

The following positions do not accrue leave and are not eligible for holidays or other fringe benefits:

• Temporary
• Provisional
• Seasonal employees

Click on the link below to explore our plans and rates.

Prince William County Benefit Programs

01

By submitting this application, I understand the following: 1) Only the information provided on my application is used to determine my qualifications; 2) My resume will not substitute for the education, work experience, and required fields on the Prince William County application; 3) Only responses to Supplemental Questions that can be verified in my submitted education and work experience will be credited and 4) If selected, my employment dates will be verified for the past three (3) years (if applicable), with a required reference from my current or most recent employer.

• Yes, I acknowledge and understand the above statement and wish to continue in this process.
• No, I do not wish to proceed any further in this process.

02

Please select your highest level of education.

• Master's degree or higher
• Bachelor's degree
• Associate's degree
• High School/ GED
• None of the above

03

Do you have 5 or more years of accounts receivable and behavioral healthcare billing, posting, collections, and administrative management experience?

• Yes
• No

04

How many years of experience do you have supervising employees responsible for healthcare billing, reimbursement, or accounts receivable functions?

• More than 10 years
• 7 - 10 years
• 4-6 years
• 1-3 years
• Less than 1 year
• No experience

05

What is the greatest number of employees you have directly supervised?

• 10 or more employees
• 7-9 employees
• 4-6 employees
• 1-3 employees
• None of the above

06

Please quantify your years of experience in managing healthcare revenue cycles.

• More than 10 years
• 6-10 years
• Less than 5 years
• No experience

07

Please select all environments in which you have direct healthcare billing or accounts receivable experience.

• Local Government
• State Government
• Federal Government
• Private Healthcare
• Community Services Board
• Behavioral Health
• Hospital
• Physician Practice
• None of the above

08

Please select all payer types with which you have direct billing experience.

• Virginia Medicaid (DMAS)
• Medicaid Managed Care Organizations (MCOs)
• Medicare
• Commercial Insurance
• Self-Pay
• Grant-funded Services
• None of the above

09

Please select all the systems you have used professionally.

• Credible
• Availity
• Cardinal Health
• CCC Plus
• Department of Medical Assistance Services (DMAS)
• Qualifacts
• Other Behavioral Health EHR
• Clearinghouse software
• Insurance Portals
• None of the above

10

If you selected other billing systems, please list them here.

11

Do you have experience working with electronic payments and importing payments from a clearinghouse?

• Yes
• No

12

Please select each type of transaction you have worked on.

• 837 Professional Claims
• 835 Electronic Remittance Advice
• 270/271 Eligibility Transactions
• 276/277 Claim Status
• Electronic Funds Transfer (EFT)
• ERA Processing
• None of the above

13

Please indicate your experience with each of the following in relation to healthcare coding.

• CPT
• HCPCS
• ICD-10-CM
• Modifiers
• Behavioral Health Coding
• None of the above

14

Please select all duties that you have performed as part of your professional responsibilities.

• Medical coding review
• Charge entry
• Claims creation and submission
• Payment posting
• Electronic payment imports
• Electronic Remittance Advice (ERA) processing
• Clearinghouse management
• Insurance portal management
• Accounts receivable follow-up
• ? Aging report analysis
• Claim denial management
• Appeals and reconsiderations
• Debt collection review
• Financial reconciliation
• Daily deposit auditing
• Financial reporting
• Revenue trend analysis
• Billing compliance auditing
• Business process improvement
• None of the above

15

Please select all areas in which you have professional experience.

• HIPAA
• Virginia Medicaid (DMAS) regulations
• Medicare regulations
• Managed Care Organization (MCO) contracts
• Federal billing compliance
• State billing compliance
• Internal billing audits
• Documentation compliance reviews
• None of the above

16

Have you represented your organization during meetings with Medicaid, Managed Care Organizations (MCOs), Medicare, or commercial insurance representatives to discuss reimbursement, denials, billing compliance, or contract performance?

• Frequently
• Occasionally
• Rarely
• No

17

Which of the following have you led or significantly contributed to? (Please select all that apply.)

• Improved billing workflows
• Reduced claims denials
• Reduced accounts receivable aging
• Increased reimbursement collections
• Implemented new billing software
• Developed billing procedures
• Trained billing staff
• Developed performance metrics
• None of the above

18

Please indicate your proficiency with the following Microsoft Office applications.

• Excel (advanced formulas, PivotTables, reporting)
• Word
• Outlook
• Teams
• PowerPoint
• Access
• None of the above

Required Question

Employer Prince William County Government

Address 1 County Complex Court

Prince William County, Virginia, 22192

Website https://www.pwcva.gov/department/human-resources/careers