About this role
Key Responsibilities:
Submit accurate and timely claims for ABA services to private insurance, Medicaid, and other payersVerify insurance eligibility and benefits for new and existing clientsTrack and follow up on unpaid or denied claims; initiate appeals as neededManage authorizations, re-authorizations, and documentation requirements for ongoing servicesReconcile payments, post EOBs, and generate client invoices as neededMaintain compliance with HIPAA, payer guidelines, and ABA-specific billing codes (e.g., CPT 97151, 97153, 97155)Collaborate with BCBAs, administrative staff, and families to resolve billing issues and ensure smooth revenue cycle operations
Requirements:
2+ years of medical billing experience, with a strong focus on ABA or behavioral health servicesProficiency in billing software and clearinghouses (e.g., CentralReach, Office Ally, Kareo, SimplePractice)In-depth knowledge of ABA billing codes, modifiers, and payer-specific requirementsStrong organizational and follow-up skillsFamiliarity with Medicaid and commercial insurance billing processesHigh attention to detail and ability to manage multiple accounts
Preferred Qualifications:
Experience with CentralReach or similar ABA-specific EMR platformsUnderstanding of insurance credentialing and contracting (a plus)Bilingual (English/Spanish) is a bonus but not required