Applied Behavior Analysis (ABA) Biller

Position Summary:
We are seeking a highly organized, detail-oriented, and experienced ABA Biller to join our team.
The ideal candidate will be responsible for managing all aspects of the billing cycle, ensuring
accurate and timely submission of claims, and maximizing revenue realization. This role
requires a strong understanding of ABA billing practices, medical coding, and proficiency with
various payer portals.

Key Responsibilities:

? Claim Submission & Management:
? Prepare and submit accurate and timely claims to various insurance payers
(commercial, Medicaid, etc.) using platforms such as Navinet, Availity, and the
Change Medicaid portal.
? Thoroughly scrub claims for errors and discrepancies before submission to
minimize denials.
? Monitor claim statuses and follow up on outstanding claims.

? Denial Management & Appeals:
? Research and resolve denied claims efficiently and effectively.
? Prepare and submit appeals for denied claims, providing necessary
documentation and justification.
? Identify trends in denials and work with the team to implement corrective
measures.

? Coding & Compliance:
? Possess a strong understanding and proper application of 971 medical codes
relevant to ABA therapy.
? Ensure all billing practices comply with HIPAA regulations and other relevant
healthcare guidelines.

? Payment Posting & Reconciliation:
? Accurately post payments and adjustments to client accounts.
? Reconcile accounts to ensure all payments are correctly applied.

? Communication & Collaboration:
? Communicate effectively with insurance companies regarding claims, denials,
and payment inquiries.
? Collaborate with clinical staff to ensure proper documentation supports billing
practices.
? Provide regular reports on billing performance and outstanding receivables.

Qualifications:
? Proven experience as an ABA Biller or medical biller with a strong focus on behavioral
health.
? Proficiency with billing software and electronic health records (EHR) systems.
? Required proficiency with Navinet, Availity, and the Change Medicaid portal.
? In-depth knowledge of CPT codes, particularly the 971 series (e.g., 97151, 97153,
97155, 97156, 97158) and their appropriate application in ABA therapy.
? Strong understanding of insurance verification, authorization, and benefit coverage.
? Excellent organizational skills and attention to detail.
? Ability to work independently and manage multiple priorities effectively.
? Strong problem-solving and analytical skills.
? Excellent written and verbal communication skills.

Education:
? High school diploma or equivalent required.
? Associate's or Bachelor's degree in healthcare administration, business, or a related field
preferred.
? Medical billing and coding certification (e.g., CPC, CBCS) is a significant plus.