Job Description

Job Description

Job Description

Job Summary:

The Billing/AR Specialist at Applied Behavior Center for Autism is responsible for managing the organization's accounts receivable processes, ensuring accurate and timely collection of payments from clients, insurance companies, and other stakeholders. This role involves working closely with the billing and insurance team as well as the providers to ensure that payments are received in a timely manner. The ideal candidate will have a strong understanding of health insurance, experience in healthcare or medical billing, and a passion for contributing to the growth and success of a center dedicated to helping children with autism.

Key Responsibilities:

1. Billing & Claims Management :

o Submit timely and accurate claims to Medicaid and commercial payers

o Monitor prior claims and aging reports and follow up on unpaid, underpaid, denied or rejected claims and ensure timely resolution

o Identify billing errors and take action to research and communicate identified issues to all team members

o Understand and apply appropriate modifiers, CPT codes and POS codes based on services rendered

2. Customer Service & Communication:

o Contact insurance companies to resolve denied, rejected or pending claims

o Provide excellent customer service to patients, addressing questions related to billing, payments, or insurance coverage

o Coordinate with internal staff to resolve documentation or billing discrepancies

o Escalate unresolved issues to leadership as appropriate

3. Documentation, Compliance & Reporting :

o Maintain accurate and up-to-date records of all payer communications, account resolutions and billing activities.

o Ensure compliance with payer-specific rules, HIPAA regulations and internal billing policies

o Track and log denials, appeals and claim follow-ups using the appropriate systems

4. Other items as needed:

o Review and assist with posting of insurance and patient payments

o Assist with insurance verification and pre-authorizations to ensure services are covered before treatment begins

Qualifications:

· Education: High School Diploma or GED required; Associate’s or Bachelor’s degree preferred.

• Experience Required: Minimum of 2 years' experience in a healthcare or medical billing environment required.
• Preferred Experience: working with ABA billing preferred.

· Skills:

o Experience in a medical billing software

o Knowledge of insurance guidelines and billing procedures, and the ability to research as needed

o Strong organizational and time-management skills, with the ability to handle multiple tasks simultaneously.

o Excellent written and verbal communication skills.

o Detail-oriented with strong problem-solving skills.

o Ability to work independently and as part of a team in a fast-paced environment.

At the Applied Behavior Center for Autism, we are proud to offer rewarding and challenging careers that truly make a difference every day. From our corporate staff to our clinical leaders to our therapists on the floor, we want each and every ABC employee to learn, grow, and reach their greatest potential. Join our team and help us build a brighter future for children and teens with autism.

Company Description

At the Applied Behavior Center for Autism, we are proud to offer rewarding and challenging careers that truly make a difference every day. From our corporate staff to our clinical leaders to our therapists on the floor, we want each and every ABC employee to learn, grow, and reach their greatest potential. Join our team and help us build a brighter future for children and teens with autism.

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