ABA (Autism) Authorization Specialist
4 weeks ago
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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Registered Behavior Technician
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RBT/Behavior Technician
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Research Visual Acuity Examiner
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