ABA Therapy Billing Specialist

3 weeks ago

NV United States Reset Behavior LLC Full time
Job Summary

The ABA Therapy Billing Coordinator plays a crucial role in the financial operations of Reset Behavior LLC, ensuring the accurate and timely submission of claims for ABA therapy services. This position requires a detail-oriented individual with a strong understanding of ABA-specific billing processes and regulations.

Key Responsibilities
  • Claim Submission: Prepare and submit accurate claims to insurance providers, adhering to coding and documentation standards.
  • CPT Code Proficiency: Utilize ABA-specific CPT codes for various therapy services, ensuring correct code selection for optimal reimbursement.
  • Insurance Verification: Conduct pre-authorization requests and verify insurance benefits for ABA services to prevent billing issues.
  • Accounts Receivable Management: Monitor accounts receivable reports, track unpaid claims, and follow up with insurance companies as necessary for resolution.
  • Patient Invoicing: Generate and send patient invoices, handle billing inquiries, and provide clear explanations of charges to clients and families.
  • Dispute Resolution: Address and resolve billing disputes or denials, working closely with clinical staff, insurance companies, and patients to ensure prompt resolution.
  • Maintain Records: Keep accurate and organized records of patient billing information, claims submissions, and payment history.
  • Collaboration: Work collaboratively with therapists, administrative staff, and management to ensure smooth billing operations and adherence to ABA therapy regulations.
  • Reporting: Prepare regular reports on billing performance, including outstanding claims, denial rates, and revenue cycle metrics to identify areas for improvement.
Requirements
  • High School Diploma or equivalent required.
  • Experience with billing operations is required.
Preferred Qualifications
  • An Associates or Bachelors Degree in Healthcare Administration, Business, or a related field is preferred.
  • A minimum of two years of experience in medical billing, particularly experience in Applied Behavior Analysis (ABA) therapy billing, is highly desired.
  • A comprehensive understanding of ABA CPT codes, insurance billing processes, credentialing, contracting, and the unique requirements associated with billing for ABA services is strongly preferred.
Additional Skills and Abilities
  • Proficient in billing software and Electronic Health Records (EHR).
  • Proficient with Google and MS Office Suite.
  • Knowledge of ABA-specific billing systems and familiarity with ABA therapy regulations, CPT coding guidelines, and insurance claim processes.
  • Strong organizational skills with a keen eye for detail to ensure accuracy in billing and coding.
  • Excellent verbal and written communication skills to communicate effectively with insurance representatives, clients, and team members.
  • Strong office administration skills and ability to operate standard office equipment.
  • Strong interpersonal and team building skills.
  • Ability to work with flexibility and adapt to changing priorities.
  • Excellent organizational skills and consistency in meeting deadlines.
  • Commitment to maintain client confidentiality and adhere to HIPPA laws.
  • Commitment to ongoing training and development as it relates to professional development, ethics, and technology.

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