Little Leaves

Role Description See how small steps bring big results for children, families, and team members alike. Work one-on-one with young children with autism to deliver individualized treatment designed by a Board-Certified Behavior Analyst. As a critical member of the child’s therapy team, you will: - Facilitate learning and playing in groups - Collect data - Implement feedback from supervisors Responsibilities - Manage initial credentialing, recredentialing, and revalidation for all providers across multiple payers and states (MD, VA, FL) - Maintain and update CAQH profiles, ensuring accuracy of provider demographics, licensure, and documentation - Ensure providers are properly affiliated with correct TINs, service locations, and state licensure requirements - Track and manage all applications using a centralized credentialing tracker - Proactively follow up with payers on pending applications (30/60/90+ days) - Escalate credentialing delays and unresolved issues through payer channels and leadership - Collaborate with billing, authorization, and clinical teams to ensure providers are cleared for billing - Identify and resolve credentialing discrepancies that may impact claims submission or reimbursement - Maintain accurate documentation of credentialing activities in internal systems - Support onboarding of new providers to ensure timely credentialing and minimal service disruption - Assist with payer demographic updates, roster submissions, and contract-related updates - Review and respond to payer correspondence related to credentialing status - Perform audits to ensure alignment between credentialing records and billing systems - Perform other duties as assigned Qualifications - 2+ years of provider credentialing experience (behavioral health or ABA preferred) - Experience working with commercial payers (UHC/Optum, Aetna, Cigna, BCBS, Kaiser, etc.) - Strong knowledge of CAQH management and provider enrollment processes - Experience with multi-state credentialing (MD, VA, FL preferred) - Understanding of state-specific licensure and payer enrollment requirements - Highly organized with strong attention to detail and follow-through - Strong communication and problem-solving skills - Experience with practice management systems (e.g., Central Reach, Motivity) preferred - Proficiency in Excel and tracking tools - Ability to manage high-volume workflows and meet deadlines - Ability to maintain confidentiality and comply with HIPAA regulations Benefits - Full insurance support to families who seek our services Posted Salary Range Starting from USD $26.45/Hr.

Role Description The ABA Authorization Specialist is responsible for managing the end-to-end authorization process to ensure all services are approved, compliant, and aligned with payer requirements prior to billing. This role is critical to maintaining continuous service delivery and revenue integrity by preventing delays, denials, and lapses in authorization coverage across MD, VA, and FL markets. - Manage submission of initial, concurrent, and renewal authorizations for ABA services - Review treatment plans to ensure alignment with payer requirements and requested units - Track and monitor all authorizations using a centralized tracking system - Proactively follow up with payers to ensure timely approval and avoid service disruptions - Communicate with clinical teams to obtain required documentation (treatment plans, assessments, progress notes) - Ensure all authorizations are in place prior to service delivery and billing - Identify and resolve authorization discrepancies, including incorrect units, dates, or service codes - Maintain accurate documentation of all authorization activity in internal systems (e.g., Central Reach / Motivity) - Monitor authorization utilization and flag overutilization or underutilization risks - Communicate authorization updates and changes to billing, scheduling, and clinical teams - Review payer policies specific to MD, VA, and FL to ensure compliance - Assist with appeals and reconsiderations for denied or reduced authorizations - Perform audits to ensure alignment between authorizations, schedules, and billed services - Perform other duties as assigned Qualifications - 2+ years of experience in ABA authorizations, utilization management, or insurance verification - Strong knowledge of ABA CPT codes (97151, 97153, 97155, 97156) - Experience working with commercial payers (UHC/Optum, Aetna, Cigna, BCBS, Kaiser, etc.) - Familiarity with state-specific authorization requirements in MD, VA, and FL preferred - Understanding of authorization requirements and documentation standards for ABA services - Experience coordinating with clinical teams for treatment plan submissions - Strong organizational skills with ability to manage multiple deadlines - High attention to detail and ability to identify discrepancies - Experience with practice management systems (Central Reach, Motivity preferred) - Proficiency in Excel and tracking tools - Ability to work in a fast-paced, high-volume environment - Strong communication and problem-solving skills - Ability to maintain confidentiality and comply with HIPAA regulations Requirements - Starting from USD $26.45/Hr.