ABA Billing Expert - 21116

Job Title: ABA Billing & Authorizations Expert

Working Hours: M-F 9:00 AM to 5:00 PM EST
Salary Range: $2,000–$3,000/month (Final offer depends on skills and experience)

About the Company
Provides in-home Applied Behavior Analysis (ABA) therapy services for children diagnosed with autism across Indiana and New Jersey.

Role Overview
We are seeking a seasoned, hands-on ABA Billing Expert with deep end-to-end revenue cycle management (RCM) and authorization management experience within an ABA agency setting. This is a high-impact, independent role for a professional who can fully own our billing operations, AR recovery, authorization workflows, and patient collections from day one with zero training required.

Key Responsibilities

End-to-End ABA Billing & Full AR Ownership (Primary Focus)

• Execute hands-on in-network and out-of-network ABA claims processing from initial entry to final payment.
• Manage coordination of benefits (COB) and accurately submit primary, secondary, and tertiary claims to commercial payers and state Medicaid programs.
• Take complete ownership of Accounts Receivable (AR), including managing aging reports, auditing underpayments, submitting corrected claims, posting ERA/EOB payments, and performing line-item balance reconciliations.
• Aggressively pursue unpaid, delayed, or denied claims through clinical appeals and payer escalations, strictly managing timely-filing deadlines to ensure zero revenue loss.
• Manage patient-responsibility billing, including generating monthly client statements, establishing payment plans, handling collections, and following up on balance-due accounts.
• Apply expert operational knowledge of ABA CPT codes (97151, 97152, 97153, 97154, 97155, 97156, 97157, and 97158).

Authorization & Reauthorization Management (Primary Focus)

• Independently manage the complete authorization and reauthorization lifecycle to guarantee uninterrupted client care.
• Gather and review all required clinical documentation, diagnostic reports, BCBA treatment plans, and clinical assessments prior to submission.
• Proactively respond to payer denials, requests for additional information (RFIs), and peer-to-peer review requirements.
• Maintain a strict authorization tracking system to monitor submission statuses, conduct payer follow-ups, and prevent expiration gaps.
• Assist with Verifications of Benefits (VOBs) as needed to confirm coverage details, deductible/copay responsibility, CPT code restrictions, and telehealth guidelines.

Systems & Operational Ownership

• Demonstrate expert, everyday working proficiency in BOTH CentralReach AND Rethink (experience with only one software is not sufficient).
• Collaborate with internal operations to align BCBA/RBT scheduling, session logs, and supervisory hours with billing rules and authorization constraints.
• Utilize clearinghouses (Availity, Waystar, Trizetto) and payer portals to audit claims daily, identify root-cause rejection patterns, and continuously optimize RCM workflows.

Candidate Requirements

• Direct ABA Company Experience Required: A minimum of 3–5 years of dedicated, direct ABA billing and authorization management experience inside an ABA therapy provider organization. Generic medical billing or general behavioral health experience alone will strictly not be considered.
• Dual Platform Mastery: Hands-on experience and proficiency in BOTH CentralReach AND Rethink practice management systems.
• Core Technical Skills: Demonstrated success managing full-spectrum AR aging, timely-filing deadlines, in-network/out-of-network claims, clinical appeals, and end-to-end authorization workflows.
• Zero-Training Expectation: Must be able to step into the role and independently run billing, AR recovery, and authorization management on Day 1 without supervision.
• Proactive Ownership: High level of autonomy, rigorous attention to detail, and a persistent follow-up strategy with insurance representatives and client accounts to ensure nothing falls through the cracks.