ABA Authorization Specialist
About The Position
The ABA Authorization Specialist is responsible for managing the authorization process for ABA therapy services, ensuring clients receive timely access to care while maintaining compliance with insurance requirements and company policies. This role works closely with clinical teams, insurance payers, and internal departments to obtain, track, and maintain service authorizations while supporting uninterrupted care for our clients. The ideal candidate is highly organized, detail-oriented, and experienced in healthcare authorizations, with a strong understanding of insurance processes and payer requirements.
Requirements
- Associate's or Bachelor's degree in Healthcare Administration, Business Administration, Psychology, or a related field preferred.
- Minimum of 2 years of experience in healthcare authorizations, insurance verification, utilization management, or a related healthcare administrative role.
- Experience with ABA therapy authorizations strongly preferred.
- Knowledge of insurance authorization processes, commercial payers, Medicaid, and managed care plans.
- Proficiency with CentralReach, including the Authorizations Module.
- Strong working knowledge of Google Workspace, including Google Sheets, Docs, Gmail, and Drive.
- Exceptional organizational skills and attention to detail.
- Excellent written and verbal communication skills.
- Ability to manage multiple priorities and meet deadlines in a fast-paced environment.
Nice To Haves
- Experience in behavioral health, ABA, or pediatric healthcare.
- Familiarity with authorization appeals and denial management.
- Experience working with multiple insurance payers across various states.
Responsibilities
- Submit, track, and manage initial, concurrent, and reauthorization requests for ABA therapy services.
- Monitor authorization status and proactively follow up with insurance providers to ensure timely approvals and prevent interruptions in care.
- Track authorization utilization and expiration dates, ensuring renewal requests are submitted within required timeframes.
- Communicate authorization approvals, denials, modifications, and requests for additional information to internal stakeholders.
- Collaborate with BCBAs and clinical teams to obtain treatment plans, assessments, progress reports, and supporting documentation required for authorization submissions.
- Verify payer authorization requirements and maintain knowledge of commercial insurance, Medicaid, and managed care guidelines.
- Assist with resolving authorization-related issues, denials, and appeals.
- Maintain accurate authorization records and documentation within CentralReach and other company systems.
- Ensure compliance with payer requirements, HIPAA regulations, and company policies.
- Support authorization reporting, audits, workflow improvements, and other administrative functions as needed.
Benefits
- Flexible schedules
- Health, Dental, Chiropractic, and Vision Insurance
- Critical Illness, Voluntary Life, Accident, Hospital Confinement, and Basic Life Insurance
- 401(k)
- Pet Insurance Discounts
- Paid Time Off
- Company-Paid Holidays (6 fixed holidays and 3 floating holidays)
- Professional Development Assistance
- Employee Referral Program
- Tuition Reduction for Partnered Universities, including National University, California Southern University, Vanguard University, Capella University, and Purdue Global
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
