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ABA Billing Specialist
3 weeks ago
- Dental insurance
- Health insurance
- Paid time off
- Parental leave
- Vision insurance
KD Care Community ABA Services is a fast-growing provider of Applied Behavior Analysis (ABA) therapy for children with autism. We are seeking a Billing Specialist with direct experience in ABA billing and Medicaid payor guidelines to ensure timely and accurate claims submission, payment posting, and denial resolution.
Position Overview:
The Billing Specialist will be responsible for processing and submitting insurance claims, reviewing billing accuracy, managing denials, and ensuring timely reimbursement in alignment with Medicaid and commercial payor requirements specific to ABA therapy services.
Key Responsibilities:
- Submit accurate and timely claims to Medicaid and commercial payors for ABA services
- Review session notes and billing data to ensure compliance with payor rules (e.g., modifiers, units, CPT codes)
- Track and resolve claim denials and underpayments, ensuring maximum reimbursement
- Monitor authorization usage and flag upcoming expirations to ensure clean billing
- Coordinate with credentialing, clinical, and intake teams to verify billing readiness
- Maintain strict confidentiality of client and financial data
- Stay current on state Medicaid policies, payor guidelines, and ABA billing regulations
- Generate and review billing reports, and assist with monthly revenue tracking
- 2–5 years of medical billing experience with at least 1 year in ABA billing required
- Experience with Medicaid, BCBS, Aetna, Meridian, or similar payors
- Knowledge of ABA-specific CPT codes (e.g., 97151, 97153, 97155, 97156, 97157)
- Familiar with billing platforms such as CentralReach, TherapyNotes, Office Ally, or similar
- Strong data entry skills
- Intermediate Excel or Google Sheets skills
- Detail-oriented, organized, and able to manage multiple priorities
- Strong verbal and written communication skills
- Experience in Michigan Medicaid ABA billing
- Familiar with DWIHN billing requirements
- Prior work in a fast-paced, multi-location behavioral health or ABA agency
- Be part of a mission-driven, growing team
- Competitive pay with room for advancement
- Supportive leadership and opportunity for cross-training
- Make a real impact helping families and children with autism
