ABA Billing Specialist

ABA Billing Specialist

The ABA Billing Specialist is a highly experienced and self-sufficient billing professional responsible for managing the full cycle of ABA billing operations from claim creation through final resolution. This role requires advanced knowledge of ABA billing practices, including CPT coding, authorization management, unit tracking, and payer-specific requirements.

The ABA Billing Specialist is responsible for ensuring the accuracy, timeliness, and completeness of all billing activities, including claim submission, payment posting, denial resolution, collections, and follow-up. This position requires strong expertise in commercial insurance and the ability to effectively manage payer relationships to resolve complex billing issues and optimize reimbursement. In addition, the ABA Billing Specialist partners with BCBAs, clinicians, and internal operational teams to support accurate documentation submission, resolve billing-related discrepancies, ensure authorization compliance, and facilitate timely claim processing and reimbursement.

• Processes and submits ABA claims for reimbursement, ensuring accurate CPT coding, modifiers, units, and payer-specific billing requirements.
• Ensures all billed services align with authorizations, including verification of approved units, service types, rendering providers, and date ranges prior to claim submission.
• Identifies, analyzes, and resolves denials, including timely resubmission, appeals, and escalation to payers as needed.
• Maintains strong working knowledge of commercial insurance plans, payer policies, and ABA-specific billing guidelines, applying this knowledge to resolve complex claim issues and prevent recurring errors.
• Manages payer interactions related to claim resolution, including follow-up, escalation, and clarification of billing requirements to support timely reimbursement.
• Posts and reconciles payments, ensuring accuracy between remittances, system balances, and financial records.
• Monitors outstanding balances, including insurance and patient responsibility, and supports resolution of aged accounts.
• Ensures timely and accurate billing of all ABA services in accordance with payer deadlines and organizational standards.
• Maintains compliance with all applicable regulatory requirements, payer guidelines, and internal policies.
• Performs other related duties as required.

1. High school diploma or equivalent is required.
2. A minimum of 3 years of experience in ABA billing for commercial insurance and Medicaid.
3. Experience with full-cycle billing processes, including claims submission, denial resolution, and payer follow-up, is required.
4. This candidate will assist in scaling up the ABA billing program

Posted Salary Range USD $27.00 - USD $30.00 /Hr.