ABA Billing Specialist I

Job description

Position Summary The ABA Billing Specialist I is responsible for managing key revenue cycle activities to support accurate billing, timely reimbursement, and effective financial operations for ABA therapy services. This role oversees claims preparation and submission, payment posting, accounts receivable follow-up, denial resolution, and patient financial responsibility processes while ensuring compliance with payer requirements and regulatory standards. The ABA Billing Specialist works closely with internal teams, including the PH Billing Team and clinical staff, to resolve billing-related issues, maintain accurate patient accounts, and support uninterrupted client care. This position requires strong attention to detail, problem-solving skills, and a commitment to ethical billing practices, HIPAA compliance, and delivering a high-quality experience for patients and families. Job Details Onsite (Eastwood) Monday to Friday, 8 am – 5 pm MST Following US Holidays Key Responsibilities: Collect patient cost shares and create payment plans for ABA therapy services. Collaborate with PH Billing Team on shared patients Support Accounts Receivable (AR) collection activities and denial management processes to ensure timely reimbursement and resolution of outstanding claims. Prepare, review, and submit claims in compliance with payer and regulatory requirements. Post payments, adjustments, and denials received from payers and patients to appropriate accounts. Conduct accurate Benefit Verifications for ABA patients. Communicate financial responsibility estimates to families based on insurance quotes. Support session notes issues identified by EMR system and collaborates with the clinical team to ensure timely resolution. Gather and organize ABA medical records for audit requests. Ensure compliance with HIPAA standards and privacy regulations. Demonstrate strong knowledge of and adherence to ethical billing practices. Position Qualifications and Credentials: Minimum of a HS Diploma Experience with administrative tasks, preferably within the context of an ABA or medical setting 1-3 years’ experience working with ABA billing and authorization processes is preferred Excellent communication, time management, problem-solving, and organizational skills