Medical Biller - ABA Therapy focus

AI overview

This role is unique in its focus on submitting timely claims for ABA therapy services while ensuring compliance with HIPAA and collaborating closely with families and healthcare professionals.

Key Responsibilities:

Submit accurate and timely claims for ABA services to private insurance, Medicaid, and other payers
Verify insurance eligibility and benefits for new and existing clients
Track and follow up on unpaid or denied claims; initiate appeals as needed
Manage authorizations, re-authorizations, and documentation requirements for ongoing services
Reconcile payments, post EOBs, and generate client invoices as needed
Maintain 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 services
Proficiency in billing software and clearinghouses (e.g., CentralReach, Office Ally, Kareo, SimplePractice)
In-depth knowledge of ABA billing codes, modifiers, and payer-specific requirements
Strong organizational and follow-up skills
Familiarity with Medicaid and commercial insurance billing processes
High attention to detail and ability to manage multiple accounts

Preferred Qualifications:

Experience with CentralReach or similar ABA-specific EMR platforms
Understanding of insurance credentialing and contracting (a plus)
Bilingual (English/Spanish) is a bonus but not required