[Hiring] ABA Medical Billing Specialist @Opal Autism Centers

Role Description

Opal Autism Centers is seeking an experienced ABA Medical Billing Specialist for a temporary revenue cycle project focused on reducing billing backlog and accelerating claim submissions. This approximately three-month contractor assignment will work closely with our Revenue Cycle team, clinical providers, and operational leaders to review billing documentation, resolve submission barriers, obtain necessary corrections or addendums, and submit accurate claims.

• This project includes established expectations for daily claim submission volume and clean-claim accuracy. Specific productivity and quality benchmarks will be discussed during the interview process.

Responsibilities

• Review, validate, and submit ABA therapy claims using CentralReach and applicable clearinghouse systems.
• Process assigned billing backlog while meeting established productivity expectations.
• Verify client demographics, authorizations, provider credentials, CPT codes, units, dates of service, and place-of-service requirements.
• Identify documentation issues that prevent claims from being submitted.
• Coordinate with BCBAs, Clinical Directors, and other providers to obtain necessary documentation corrections and addendums.
• Review claims for payer-specific billing requirements before submission.
• Help prevent duplicate billing and authorization utilization errors.
• Maintain accurate billing records and supporting documentation.
• Follow HIPAA and organizational privacy and security requirements.
• Review rejected, held, or otherwise unsubmitted claims.
• Research payer requirements and claim rejection reasons.
• Correct billing errors and resubmit claims when appropriate.
• Identify and escalate recurring billing barriers or trends.
• Document follow-up activity and claim resolutions accurately.
• Track daily claim submission volume and backlog reduction progress.
• Provide regular project status updates to Revenue Cycle leadership.
• Communicate professionally with providers regarding missing or incomplete documentation.
• Participate in scheduled project meetings as needed.

Qualifications

• At least 3 years of medical billing experience.
• At least 2 years of ABA therapy billing experience.
• Experience with CentralReach billing functions.
• Strong knowledge of ABA CPT codes and payer billing requirements.
• Experience using Waystar or a comparable healthcare clearinghouse.
• Ability to review and interpret EOBs, remittance advice, payer communications, and claim rejections.
• Experience managing high-volume claim submission workloads.
• Strong attention to detail and billing accuracy.
• Strong organizational and time-management skills.
• Ability to work independently and consistently meet established productivity expectations.
• Must have reliable high-speed internet access and maintain a secure, professional remote work environment appropriate for handling protected health information.

Preferred Qualifications

• Pediatric healthcare billing experience.
• Experience reducing billing backlogs or resolving aged revenue.
• Knowledge of commercial insurance, Medicaid, and managed care billing requirements for ABA services.
• Advanced Microsoft Excel and reporting skills.

Benefits

• Competitive hourly compensation.
• Approximately 40 hours per week.
• Monday through Friday schedule.
• Standard business hours.
• No regular evenings or weekends.
• Company-provided laptop and required systems access.
• Training on internal billing workflows and procedures.
• Consistent project-based workload.
• Opportunity to work on a focused ABA revenue cycle project.
• Collaboration with experienced Revenue Cycle and clinical teams.

Equipment and Systems

• Company-issued laptop.
• Secure access to CentralReach and Clearinghouse.
• Access to applicable clearinghouse platforms and payer portals.
• Microsoft Outlook, Teams, and other required communication tools.
• Training on internal billing workflows and procedures.