Billing Specialist

We are a growing healthcare organization providing ABA therapy services, and we are seeking an organized, detail-oriented Billing Specialist to join our team. In this role, you will own the full billing cycle, from clean claim submission and payment posting to claim follow-up and A/R reporting. The ideal candidate has hands-on ABA billing experience, works accurately and reliably, and communicates well with insurance companies and our clinical team.

Responsibilities:

• Submit claims weekly, including time sheet audits for duplicates, location errors and MUE issues, and task necessary corrections before submission
• Submit and monitor primary and secondary claims in Central Reach and Change Healthcare, and through payer portals as needed
• Submit periodic attestations as required by payers
• Assist in setting up and maintaining billing codes and modifiers, and monitor fee schedules
• Create and monitor patient responsibility invoices
• Follow up regularly with insurance companies to track the status of outstanding claims and resolve issues delaying payment, documenting all communication
• Post payments and adjustments accurately in Central Reach and upload Explanation of Benefits to the matching billing entries
• Review recoupment requests and monitor chargeback posting
• Process and resolve denied or rejected claims by identifying issues and making the appropriate corrections
• Monitor payer updates and review payer-specific provider manuals to assure compliance
• Work closely with the clinical team to gather any additional documentation needed to resolve claims
• Prepare monthly A/R reports
• Follow all company policies and procedures for HIPAA compliance

Qualifications:

• Prior ABA billing experience required
• Experience submitting claims in Central Reach required
• Change Healthcare clearinghouse experience preferred
• Strong computer skills, including Microsoft 365
• Basic understanding of CPT codes used in ABA billing, POS code application and MUE rules
• Strong written and spoken English
• Strong attention to detail and organization, with the ability to maintain confidential records
• Reliable, flexible and able to work with minimal supervision