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