Billing Specialist - ABA Therapy

About the role

A growing healthcare organization providing ABA therapy services is looking for an organized, detail-oriented Billing Specialist. You will own the full billing cycle, from clean claim submission and payment posting to claim follow-up and accounts receivable reporting. The ideal candidate has hands-on ABA billing experience, works accurately and reliably, and communicates well with insurance companies and the clinical team.

Key responsibilities

• Submit claims weekly, including time-sheet audits for duplicates, location errors and MUE issues, and make necessary corrections before submission
• Submit and monitor primary and secondary claims in Central Reach and Change Healthcare, and through payer portals as needed
• Submit periodic attestations as required by payers
• Assist in setting up and maintaining billing codes and modifiers, and monitor fee schedules
• Create and monitor patient responsibility invoices
• Follow up regularly with insurers on outstanding claims and document all communication
• Post payments and adjustments accurately in Central Reach and upload Explanation of Benefits to the matching entries
• Review recoupment requests and monitor chargeback posting
• Process and resolve denied or rejected claims, and monitor payer updates and provider manuals for compliance
• Work with the clinical team to gather additional documentation needed to resolve claims
• Prepare monthly A/R reports and follow HIPAA compliance policies

Required profile

• Prior ABA billing experience required
• Experience submitting claims in Central Reach required; Change Healthcare clearinghouse experience preferred
• Strong written and spoken English
• Attention to detail and organization, with the ability to maintain confidential records
• Reliable, flexible and able to work with minimal supervision

Required skills

• Strong computer skills, including Microsoft 365
• Basic understanding of CPT codes used in ABA billing, POS code application and MUE rules