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ABA Authorization Specialist
Location
United States
Posted
57 days ago
Salary
$26 / hour
Seniority
Mid Level
No structured requirement data.
Job Description
ABA Authorization Specialist
Little Leaves
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.
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