ABA Billing Specialist

About Us:
Bloom & Thrive ABA is a leading provider of Applied Behavior Analysis (ABA) services dedicated to enhancing the lives of individuals with autism spectrum disorder (ASD) and other developmental disabilities. Our team is passionate about delivering high-quality, individualized therapy to support the unique needs of each client and their families.

Position Overview:
We are seeking a skilled and detail-oriented Pediatric Medical Coding and Billing Specialist to join our team. The Billing Specialist will play a crucial role in ensuring the timely and accurate processing of insurance claims and invoices for our ABA services. The candidate should have a clear understanding of healthcare claims processing. Candidate is preferred to be a Certified Professional Coder who can review patient records to ensure the accuracy of coding and billing compliance of ICD-10 and CPT Codes for claim scrubbing with ease. They will manage insurance AR claims by ensuring accurate and timely follow-up to ensure accuracy. Also, a knowledge of insurance payment posting. The ideal candidate will have experience in medical billing, particularly within the field of ABA therapy, and possess strong communication and organizational skills.

Roles and Responsibilities include, but not limited to:

Completing billing services for current and future clients.

• Review billing entries for correctness
• Generate and submit insurance claims for ABA therapy services in accordance with payer requirements and guidelines.
• Collaborate with patients, parents, and insurance companies for eligibility, benefits, and claims
• Review and reconcile client accounts to ensure accurate billing and payment posting
• Post payments received from payers
• Follow up on outstanding claims and denials to facilitate prompt resolution.
• Collaborate with team members to address billing-related inquiries from clients, insurance companies

Inquires and Referrals

• Receive referrals from physician’s office
• Communicate with physician’s office and parents
• Input information into EMR system

Scheduling Appointments and Mailing Packets

• Schedule tours for director of clinical services
• Schedule intake sessions and diagnostic testing for clinical psychologist
• Schedule ABA assessments for learners who plan to enroll in ABA services
• Prepare, mail, and manage all packets related to diagnostic services and ABA enrollment

Prior Authorizations

• Prepare and manage Prior Authorizations for ABA services
• Communicate authorization and reauthorization needs with Program Managers (BCBAs)
• Input authorization information into billing system
• Send medical records and other documentation to payers as requested

Development and Maintenance of Systems

• Maintain current/updated copies of all insurance cards for all learners (update yearly or with changes)
• Conduct monthly eligibility and benefit verification
• Complete inquiry lists

Assist Billing Supervisor

• Assist with administrative duties as needed
• Communicate insurance responsibilities with families
• Understand industry-specific policies and standards (i.e. HIPPA)

Company Expectations

• Maintain positive interactions with employees
• Adhere to company policy
• Conduct other responsibilities as determined by the organization
• Meet daily, monthly, and quarterly billing with supervisor
• Maintain up-to-date knowledge of billing regulations, coding guidelines, and industry best practices.

Bloom & Thrive ABA reserves the right to add or suspend any or all roles and responsibilities.

Qualifications:

• 1-3 years of ABA billing or related healthcare experience
• Healthcare or Billing Certification preferred
• Experience in Behavioral and/or Mental Health billing preferred
• Proficient in CPT and ICD-10 coding and medical terminology
• Knowledge of HIPAA and other critical governmental regulations
• Solid understanding of the healthcare industry and revenue cycle process
• Organized and detail-oriented
• Ability to comprehend insurance documentation and follow detailed procedures in an organized and efficient manner
• Ability to multi-task and meet deadlines
• Superior communication, problem-solving and follow-up skills
• Strong computer skills (Word, Excel, Google Suites, billing software)

We are supportive of all individuals and strive for a diverse work culture by being an equal opportunity employer. Apply today!

Benefits:

• Competitive pay commensurate with experience.
• Flexible Schedule
• Insurance: Medical, Dental, Vision
• Paid Time Off

Job Type: Full-time

Pay: $18.00 - $23.00 per hour

Benefits:

• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday

Work setting:

• Hybrid work
• Office

Ability to Relocate:

• Burgess, VA 22432: Relocate before starting work (Required)

Work Location: Hybrid remote in Burgess, VA 22432