ABA Medical Biller

Job Summary:

We are seeking an experienced ABA Medical Biller to manage the billing and reimbursement process for Applied Behavior Analysis (ABA) therapy services. The ideal candidate will have expertise in medical billing, coding, and insurance claims processing related to ABA therapy, ensuring accurate and timely reimbursement. This role requires a strong understanding of CPT codes, insurance verification, authorizations, and denial management to support providers and optimize revenue cycle efficiency.

Key Responsibilities:

Claims Submission & Billing: Accurately prepare, submit, and track ABA therapy claims to private and government payers.

Insurance Verification & Authorization: Verify patient benefits, obtain prior authorizations, and ensure proper documentation for ABA services.

Denial Management: Investigate, appeal, and resolve denied or underpaid claims to maximize reimbursement.

Coding Compliance: Ensure correct use of CPT, HCPCS, ICD-10 codes, and modifiers for ABA billing.

Payment Posting & Reconciliation: Apply payments, reconcile discrepancies, and follow up on unpaid claims.

Provider & Client Communication: Collaborate with BCBAs, RBTs, and administrative staff to resolve billing issues and ensure compliance.

Regulatory Compliance: Stay updated on ABA billing regulations, HIPAA, and payer policies to ensure accurate claim processing.

Qualifications & Skills:

Experience: Minimum 2+ years in ABA medical billing or healthcare revenue cycle management.

Education: High school diploma or equivalent (Associates or Bachelors degree in healthcare administration is a plus).

Technical Skills: Proficiency in ABA billing software, EHR systems, and clearinghouses (e.g., CentralReach, Kareo).

Knowledge: Strong understanding of ABA therapy billing guidelines, Medicaid, commercial insurance policies, and payer requirements.

Detail-Oriented: Ability to analyze claims, identify errors, and implement corrective actions.

Problem-Solving: Strong skills in claims resolution, appeals, and insurance communication.

HIPAA Compliance: Maintain confidentiality and comply with all healthcare regulations.:

Claims Submission & Billing: Accurately prepare, submit, and track ABA therapy claims to private and government payers.

Insurance Verification & Authorization: Verify patient benefits, obtain prior authorizations, and ensure proper documentation for ABA services.

Denial Management: Investigate, appeal, and resolve denied or underpaid claims to maximize reimbursement.

Coding Compliance: Ensure correct use of CPT, HCPCS, ICD-10 codes, and modifiers for ABA billing.

Payment Posting & Reconciliation: Apply payments, reconcile discrepancies, and follow up on unpaid claims.

Provider & Client Communication: Collaborate with BCBAs, RBTs, and administrative staff to resolve billing issues and ensure compliance.

Regulatory Compliance: Stay updated on ABA billing regulations, HIPAA, and payer policies to ensure accurate claim processing.