[Hiring] Medical Necessity Specialist @ABC

Role Description

We are looking for an assertive and driven clinical professional to join our team in a crucial administrative role to help our ABA Therapy organization grow! Action Behavior Centers is a leading development organization for children with autism based out of Austin, Texas. This role will support the Vice President of Clinical Services, the Director of Clinical Advocacy and Authorizations, and the Regional Autism Advocate(s) with time-sensitive documentation fidelity and discuss clinical needs with insurance companies.

• Assisting Regional Autism Advocate(s) in campaigning to insurance companies on patient services
• Review and confirm patient intake paperwork
• Review & proofread patient reports provided by BCBAs and prepare patient documents for insurance authorization requirements
• Manage & upkeep patient paperwork in SalesForce
• Participate in meetings with the Corporate Team
• Maintain patient communication with the Office Managers across all ABC locations
• Assist Regional Autism Advocate(s) and Director of Clinical Advocacy and Authorizations with Ad Hoc projects
• Oversee and maintain the company's healthcare data entry procedures within HIPAA compliance guidelines
• Confirm authorization via phone calls, and enter authorization documents quickly and accurately
• Confirm, maintain and enter patient's healthcare and authorization information with sensitivity and discretion into the EMR/billing system
• Fax and submit for authorization of treatment
• Schedule Peer-to-Peer (P2P) calls for insurance companies
• Account for submission and resubmission to new insurance companies with updated paperwork

This position is remote (quarterly/semi-annual travel to Austin). If in Austin, 2x per week attendance in HQ is required.

Qualifications

• Registered Behavior Technician (RBT) required; An RBT with 2+ years of clinical experience is preferred
• Working knowledge and understanding of Applied Behavior Analysis (ABA) therapy is strongly recommended
• Previous experience negotiating with insurance companies
• A strong, pleasant personality with a high EQ
• Extremely detail-oriented
• Assertive and strong communication style
• High-level of organizational skills
• Undergraduate degree is ideal but not required

Requirements

• Familiarity with SalesForce is recommended but not required
• Ideal candidate will be a RBT having worked in the field with various demographics of children impacted with Autism
• Hunger for continued growth in knowledge of ABA & Autism services
• Registered Behavior Technician (RBT) completing their Master’s Program to become a Board Certified Behavior Analyst (BCBA) with only indirect hours left to be able to sit for the Behavior Analyst Certification Board (BACB) Exam to become a BCBA would be ideal

Benefits

• 10 Days of PTO, 10 Paid Holidays, 2 Flex Days + More with Tenure
• Student Loan Repayment Employer Contributions
• Maternity/Paternity Award of up to $3,000 & FSA Options for Childcare
• Door Dash Pass and Regional Night of Honors
• Up to $600 Student Loan Repayment Options & Tuition Discounts
• Professional development opportunities
• Leadership opportunities
• 401K Retirement Plans with company matching