ABA (Autism) Authorization Specialist

1 week ago

Katy, United States Reliant Healthcare Group Full time
Job DescriptionJob DescriptionSalary: $18.00 to $21.00/Hour

The primary role of the authorization specialist is to obtain insurance authorization and to maximize reimbursement for services rendered.


DUTIES AND RESPONSIBILITIES:

 

  • Follow-up with insurance companies to complete authorizations
    • Ensure all information was submitted
    • Complete Verbal Auth Forms for new treatment requests
    • Compare treatment plans with approved hours to ensure the correct hours were given
  • Manage, track, and update authorized hours for clients
  • Monitor authorization expiration dates to ensure treatment plans are submitted in a timely manner.
    • Identify barriers to obtaining appropriate and timely service authorizations and report to manager.
  • Send authorization updates to BCBAs
    • Include breakdown of hours received
    • Notes for the next re-assessment period.
  • Schedule Peer Reviews with BCBAs and insurance companies
  • Send authorization reminders to BCBAs each month to ensure all authorizations are completed in a timely manner.
  • Input authorization information into Central Reach for billing purposes.
  • Utilize reports to ensure that all services are authorized.
  • Review converted timesheets for the previous day for all codes and different levels of therapists.
    • Ensure correct procedure coding is used per time sheet and by all different levels of therapists.
    • Check conversion times against the sign-in sheet and the schedule to ensure all timesheets were entered and converted.
    • Check the locations of the timesheets to match the location of the appointment
    • Check for overlaps and duplicate appointments
    • Resolve and/or communicate any discrepancies
  • Ensure Magellan/TriCare hours do not exceed the threshold
  • Assist in collecting, posting, and monitor patient accounts
  • Recognize problems and communicates them to appropriate personnel. 
  • Performs other duties as assigned by administrator/ office manager. 

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