ABA Authorization Specialist
AI Summary
Supports ABA therapy revenue cycle by verifying insurance eligibility, obtaining and tracking authorizations, and ensuring accurate documentation in the EMR system.
About this role
Position Summary
The ABA Authorization Specialist is responsible for supporting the revenue cycle management process by ensuring timely insurance verification, authorization approvals, and accurate documentation for ABA therapy services. This role serves as a key liaison between families, insurance providers, billing specialists, and clinical teams to facilitate seamless service delivery and maintain compliance with payer requirements.
The ABA Authorization Specialist plays an essential role in improving operational efficiency, maintaining accurate records in the EMR system, and contributing to a collaborative, ethical, and high-performing ABA RCM team environment. The position requires strong communication, attention to detail, and problem-solving skills to monitor authorization processes, track insurance requirements, resolve barriers, and support continuity of care.
Job Details:
Onsite (Eastwood)
Monday to Friday, 8 am – 5 pm MST
Following US Holidays
Key Responsibilities:
- Verify patient’s insurance eligibility and benefits for ABA therapy
- Communicate financial responsibility estimates to families based on insurance quotes
- Partner with ABA Billing Specialists to identify patient responsibility amounts and ensure accurate collection expectations at the time of service.
- Obtain, monitor, and track referrals to ensure services are authorized and compliant with payer requirements
- Conduct follow-up communications with insurance carriers to obtain and monitor authorization status, ensuring timely approvals and continuity of care
- Monitor and track insurance requirements
- Follow up with clinical staff regarding missing treatment plans and discharge reports to ensure timely completion
- Secure ABA authorization for assessments and support with initial ABA therapy and ongoing ABA therapy authorizations
- Enter authorization information into the EMR system, to ensure that ABA therapy sessions can be scheduled and billed appropriately
- Stay current with authorization processes and requirements for each funding source
- Support with other tasks as needed within the ABA RCM department
Position Qualifications and Credentials:
- Minimum of a HS Diploma
- Experience with administrative tasks, preferably within the context of an ABA or human services/medical setting
- 1-3 years’ experience working with funding sources and/or authorization processes is preferred Excellent communication, time management, problem solving, and organizational skills
Skills
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