ABA/Psych Billing Specialist

Job Title: Billing Specialist (ABA Specific)

Job Type: Non-Exempt, Full-Time

Location: Corporate

Reports to: COO

Position Overview:

The Billing Specialist at Key Essentials to Behavior Management is responsible for managing and coordinating the billing process specifically related to Applied Behavior Analysis (ABA) services. This critical role ensures accurate and timely billing of ABA services to insurance companies and clients, while also ensuring compliance with insurance requirements and regulations. The Billing Specialist will collaborate with therapists, case managers, and administrative staff to ensure efficient and effective billing processes.

Responsibilities:

• ABA Billing Management:
  • Review and verify billing information for accuracy and completeness specific to ABA services.
  • Submit claims for ABA services to insurance companies and follow up on any denied or rejected claims.
  • Collaborate with therapists and case managers to ensure proper completion of ABA billing documents and claim forms.
  • Monitor and reconcile payments received from insurance companies and clients for ABA services.
  • Follow up on any outstanding payments or billing discrepancies related to ABA services.
• Insurance Coordination for ABA Services:
  • Work closely with insurance providers to verify coverage and secure necessary authorizations for ABA services.
  • Liaise with clients and their families to gather insurance information and necessary documentation specific to ABA services.
  • Conduct insurance eligibility checks to determine coverage terms and limitations for ABA services.
  • Collaborate with therapists and administrative staff to ensure proper completion of insurance claim forms for ABA services.
  • Resolve any insurance-related inquiries or concerns from clients, families, or insurance representatives pertaining to ABA services.
• Documentation and Record Keeping:
  • Organize and maintain billing records specific to ABA services in compliance with company policies and regulatory requirements.
  • Ensure all ABA billing documentation is filed appropriately and easily accessible.
  • Conduct regular audits of ABA billing records to ensure accuracy and completeness.
  • Assist in the development and implementation of record-keeping systems and processes specific to ABA services.
• Communication and Collaboration:
  • Communicate regularly with therapists, case managers, and administrative staff to ensure seamless coordination of ABA billing processes.
  • Provide timely and accurate information to stakeholders regarding ABA billing requirements and processes.
  • Collaborate with team members to develop and implement strategies for improving ABA billing efficiency and accuracy.
  • Participate in team meetings and contribute to the development of policies and procedures related to ABA billing.
• Compliance and Regulatory Responsibilities:
  • Stay up to date with relevant laws, regulations, and industry standards specific to ABA billing.
  • Ensure compliance with insurance requirements and regulations related to ABA services.
  • Adhere to ethical standards in all aspects of ABA billing.
  • Assist in conducting internal audits and quality assurance activities specific to ABA billing.
• Problem-solving and Conflict Resolution:
  • Identify and address any issues or concerns related to ABA billing processes.
  • Work collaboratively with stakeholders to resolve conflicts and address challenges specific to ABA billing.
  • Provide guidance and support to therapists and administrative staff in resolving ABA billing-related issues.
  • Escalate complex or high-risk ABA billing issues to appropriate management personnel.
• Training and Education:
  • Assist in the development and delivery of training programs for therapists, case managers, and other relevant personnel specific to ABA billing.
  • Stay updated on best practices in ABA billing and insurance requirements for ABA services.
  • Provide education and guidance to clients and their families regarding ABA billing processes and insurance coverage.
• Continuous Improvement:
  • Identify opportunities for process improvement specific to ABA billing and recommend changes to enhance efficiency and accuracy.
  • Proactively seek feedback from therapists, case managers, and other stakeholders to identify areas for improvement in ABA billing.
  • Contribute to the development and implementation of quality improvement initiatives related to ABA billing.
• Professional Development:
  • Stay updated on industry trends and advancements in ABA billing and insurance requirements for ABA services.
  • Seek professional development opportunities to enhance knowledge and skills in ABA billing.
  • Maintain relevant certifications and licenses as required.
• Team Collaboration:
  • Collaborate with other billing specialists and administrative staff for smooth workflow and effective communication across departments.
  • Support colleagues in their duties as needed.
  • Foster a positive and collaborative team environment.

Qualifications:

• Minimum high school diploma or equivalent; Bachelor's degree in a related field is preferred.
• Previous experience in billing, preferably in the ABA field.
• Knowledge of insurance requirements and regulations specific to ABA services.
• Proficiency in using billing software and electronic health record systems.
• Strong attention to detail and excellent organizational skills.
• Excellent communication and interpersonal skills.
• Problem-solving and conflict-resolution abilities.
• Ability to work independently and as part of a team.
• Knowledge of HIPAA and other privacy regulations.

Physical Requirements

Occasional Requirements (1-3 hours): Sitting, standing, walking, simple grasping, power grasping, pushing, pulling, reach above shoulder, reach waist level, reach below waist, reach below knee, ending, twisting, kneeling, squatting, driving personal vehicle.

Rare Requirements (0-1): Hand and wrist work, keyboarding, fine manipulation, climbing stairs, lifting/carrying 1-50lbs.

The field of Applied Behavior Analysis may involve direct contact with individuals that may potentially exhibit aggressive and/or extremely challenging behaviors (i.e. spitting, hitting, kicking, throwing of objects, etc.).

Salary : $20 - $26