ABA Authorizations Specialist

Position Overview

The ABA Authorization Specialist is responsible for managing the full authorization lifecycle for ABA services, including initial assessments, treatment authorizations, reauthorizations, denials, and appeals. This role ensures timely approvals, accurate documentation, and continuity of patient services while maintaining compliance with payer requirements.

Key Responsibilities

1. Authorization Management

• Prepare, submit, and manage all initial, ongoing, and service authorization requests.
• Monitor authorization expiration dates, approved units, CPT codes, and service limitations.
• Proactively submit reauthorizations to prevent service interruptions.
• Follow up with insurance payers on pending requests through final determination.
• Ensure approved authorizations accurately reflect requested services and treatment needs.

2. Denials & Appeals

• Review and address denied, partially approved, or reduced authorization requests.
• Prepare, submit, and track reconsiderations, appeals, and peer-to-peer review requests.
• Coordinate with clinical teams to obtain supporting documentation and medical necessity justifications.
• Escalate urgent authorization issues and ensure timely resolution.

3. Insurance & Payer Coordination

• Verify insurance eligibility, benefits, and authorization requirements.
• Maintain knowledge of commercial, Medicaid, and managed Medicaid payer policies.
• Communicate with insurance companies to resolve authorization issues, discrepancies, and delays.
• Ensure submissions meet payer-specific documentation and deadline requirements.

Compensation & Benefits

• Full-time position (40 hours per week)
• $26-$28 per hour
• Eligible for company benefits

Qualifications

• 1+ year of experience managing ABA authorizations and insurance approvals.
• Knowledge of ABA CPT codes, authorization processes.
• Experience with commercial insurance, Medicaid, and managed Medicaid plans.
• Familiarity with denials, appeals, EHR systems, and insurance portals.
• Strong organizational, communication, multitasking, and problem-solving skills.
• Ability to independently manage a high volume of cases while meeting deadlines.

Pay: $26.00 - $28.00 per hour

Expected hours: 40.0 per week

Benefits:

• Dental insurance
• Flexible spending account
• Health insurance
• Health savings account
• Paid time off
• Referral program
• Vision insurance

Experience:

• ABA insurance authorizations: 1 year (Required)

Work Location: Remote