Job description

New Spectrum Health, an ABA agency is looking for a full time ABA Billing Specialist.

Minimal Qualifications and Experience:

• 2 year of experience submitting ABA claims to commercial and Medicaid plans
• Experience with secondary billing process
• Knowledge of denials, corrections and appeals process
• Proficient in Central Reach and Change Health Clearing House
• Proficient in Excel
• Excellent organizational skills with attention to detail
• Comprehensive understanding of account reconciliation
• High school diploma or equivalent

Job Duties:

• Configure authorization set up in Central Reach.
• Maintain billing codes, modifiers and contracted rates in Central Reach.
• Monitor authorization expiration dates and communicate upcoming expirations with providers.
• Monitor and audit scheduling conversions.
• Audit billing entries for duplicate, overlaps and POS.
• Prepare, review and submit insurance claims and private invoices weekly.
• Monitor claims for correct paid rate and network status.
• Prepare monthly account receivable report.
• Post and reconcile payments received (ERA and manual).
• Configure ERA and EFT settings for new payers.
• Follow up on denials, missing payments, submit appeals as needed.
• Document calls with insurance companies and clients.
• Assist families with patient responsibility payments and payment plan set ups.
• Assist in evaluating insurance operations and identifying efficiency improvements.
• Other duties as assigned by Leadership.

Job Type: Full-time

Schedule:

• Monday to Friday

Experience:

• submitting ABA claims to commercial and Medicaid plans: 2 years (Required)

Work Location: Remote

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