Billing Support Specialist

Position Overview

We are seeking a detail-oriented and motivated Billing Support Specialist to join our team. This role is critical to maintaining the financial health of our organization by managing the full revenue cycle for Applied Behavior Analysis (ABA) services. The ideal candidate will have at least one year of experience in billing, with a strong emphasis on commercial insurance billing, data collection, and accuracy in financial processes.

Responsibilities include timely and accurate claim submission, payment posting, denial management, collections, and follow-up on outstanding accounts. This position supports providers, clients, and administrative staff to ensure compliance with payer requirements, maximize revenue, and maintain efficient financial operations.

Billing & Data Management

• Accurately enter, track, and maintain billing data within company systems.
• Collect, verify, and organize data needed for billing, reporting, and audits.
• Prepare billing reports and summaries for management as needed.
• Support internal and external communication regarding billing inquiries.
• Provide administrative support to ensure efficient billing operations.

Claims Management

• Prepare, review, and submit electronic and paper claims (CMS-1500) through clearinghouses (e.g., Office Ally, Availity).
• Verify accuracy of CPT codes (97153, 97155, 97156, etc.), modifiers, place of service codes, and authorizations prior to submission.
• Monitor clearinghouse rejections and payer denials; correct and resubmit claims promptly.
• Follow up on outstanding accounts to ensure timely reimbursement.

Revenue Cycle & Payments

• Post payments and adjustments from Explanation of Benefits (EOBs) and Electronic Remittance Advices (ERAs).
• Reconcile payments against billed charges and resolve underpayments.
• Track outstanding claims, initiate appeals, and resolve payer issues to maximize collections.

Eligibility & Authorizations

• Verify client insurance eligibility, benefits, and coverage for ABA services.
• Track and manage authorizations to ensure services are scheduled and billed within approved limits.

Reporting & Compliance

• Generate and maintain financial and productivity reports (e.g., aging, collections, write-offs, AR by payer).
• Ensure compliance with HIPAA, payer-specific billing requirements, and company policies.
• Stay updated on insurance regulations, coding changes, and ABA billing best practices.

Collaboration & Support

• Collaborate with billing team members to resolve discrepancies, denials, or rejections.
• Work with clinicians, schedulers, and administrative staff to ensure accurate billing processes.
• Communicate with parents/guardians regarding billing inquiries, balances, and payment plans.
• Provide training and support to staff on billing procedures and documentation requirements.

Qualifications

• High school diploma or equivalent required; Associate’s or Bachelor’s degree preferred.
• Minimum 1+ years of medical billing experience, preferably in ABA or behavioral health, with commercial insurance.
• Strong knowledge of billing processes, including claims submission, payment posting, reconciliation, and denial management.
• Familiarity with CPT codes for ABA services (97151, 97153, 97155, 97156, 97157, 97158).
• Experience using EHR and billing software such as CentralReach, Office Ally, or Availity (preferred).
• Proficiency in Microsoft Office Suite (Excel, Word, Outlook).
• Excellent data entry skills with strong attention to detail and accuracy.
• Strong organizational and time management skills, with the ability to meet deadlines.
• Effective written and verbal communication skills for interacting with staff, clients, and insurance representatives.
• Ability to work independently as well as collaboratively within a team.