ABA Billing Specialist (REMOTE) - (Texas ONLY) Must have Central Reach Experience

Summary

Little Spurs Pediatric Urgent Care, including Little Spurs Autism Centers, provides pediatric urgent care and autism services. The ABA Billing Specialist manages billing, coding, claims, accounts receivable, reimbursements, compliance, and payment posting while resolving billing issues and supporting providers and staff.

Responsibilities

• Performs all necessary tasks to provide overall direction and support in billing, accounts receivable and related areas
• Responsible for managing the charge capture, coding, billing and billing edits
• Responsible for coordinating with providers and Regional Medical Directors to create efficient, accurate templates and automated charging/billing processes
• Analyze trends, impacting charges, coding, and collections and take appropriate action to realign staff and revise policies
• Analyze billing and claims for accuracy and completeness and submit claims to proper insurance entities and follow up on any issues
• Ensures that the correct coding and compliance guidelines are being adhered to
• Maintains systems, policies & procedures to ensure compliance with all contractual obligations of payers
• Responsible for monitoring reimbursements
• Responsible for staying familiar with federal and state regulations and company policies
• Effectively communicates to employees and hold yourself accountable for meeting those same expectations
• Assists with staff communication providing updates, resolving issues, setting goals and maintaining standards
• Assists with work allocation and problem resolution
• Assists with month end reports
• Performs other related duties as assigned
• Performs appropriate billing/payment posting functions as assigned
• Follows up on unpaid or improperly paid claims as necessary
• Reviews and monitors select accounts within the accounts receivable system
• Determines and performs appropriate collection efforts to resolve accounts, to include follow-up online, by phone and written correspondence
• Effectively applies protocol in company EMR: Invoice Balance Responsibility/Applies Invoice Status correctly
• Builds claims and applies knowledge of medical terminology, ICD/CPT codes to complete daily
• Corrects denied submission and denied claims in a timely manner and notes invoice accordingly
• Submits claims electronically and by paper
• Assist with telephone inquiries and billing questions promptly, with professionalism and courtesy
• Generates and reviews patient statements effectively and ensures appropriate collection correspondence is sent and documented per protocol

Skills

• High school diploma or equivalent required
• 3 + years of billing and coding experience in ABA therapy specialty
• Must possess in-depth knowledge of medical billing
• Experience with robust practice management/EMR system, preferablyCentral Reach and Waystar
• Comprehensive knowledge of coding, billing, processes and requirements
• Knowledge of local payers, to include billing and claims resolution processes
• Knowledge in physician practice technology as it relates to creating, transmitting and collecting claims
• Knowledge of physiology, anatomy, neurology and medical terminology
• Ability to communicate clearly both written and verbally
• Ability to work independently with detail and accuracy
• Excellent interpersonal communication skills
• Ability to act with discretion, tact, and professionalism in all situations
• Ability to work in a remote or hybrid work environment
• Ability to work well within a team dynamic
• Proficiency in Microsoft Office Suite (Word, Excel, Outlook, PowerPoint)
• Ability to use a fax machine, copier and a scanner
• Must have a passion for Revenue Cycle and a positive mindset
• Associates or bachelor's degree in Finance, Accounting, Business Administration, or related field preferred
• Experience with pediatric billing preferred
• Bilingual a plus!

Qualifications

Must Haves

• High school diploma or equivalent required
• 3 + years of billing and coding experience in ABA therapy specialty
• Must possess in-depth knowledge of medical billing
• Experience with robust practice management/EMR system, preferablyCentral Reach and Waystar
• Comprehensive knowledge of coding, billing, processes and requirements
• Knowledge of local payers, to include billing and claims resolution processes
• Knowledge in physician practice technology as it relates to creating, transmitting and collecting claims
• Knowledge of physiology, anatomy, neurology and medical terminology
• Ability to communicate clearly both written and verbally
• Ability to work independently with detail and accuracy
• Excellent interpersonal communication skills
• Ability to act with discretion, tact, and professionalism in all situations
• Ability to work in a remote or hybrid work environment
• Ability to work well within a team dynamic
• Proficiency in Microsoft Office Suite (Word, Excel, Outlook, PowerPoint)
• Ability to use a fax machine, copier and a scanner
• Must have a passion for Revenue Cycle and a positive mindset

Nice to Haves

• Associates or bachelor's degree in Finance, Accounting, Business Administration, or related field preferred
• experience with pediatric billing preferred
• Bilingual a plus!

Benefits

• Medical, Dental & Vision Benefits available to employee, spouse, and dependents
• Voluntary Short-Term & Long-Term Disability and Voluntary Life Insurance for employee, spouse, and children
• 401k with 4% company match on 5% employee contribution
• Holiday pay; closed Thanksgiving and Christmas with shorter holiday hours
• 80 hours of PTO accumulated through the year, available for rollover
• More PTO accrued after three and five years of service
• Free in-house medical care for employee and dependent children
• Employee recognition and appreciation programs
• Professional Development Opportunities
• 100% remote work arrangement for Texas-based employees