Single Case Agreement Specialist

LTE Care Plus Inc.•Town of Huntington, NY

About The Position

LTE Care Plus is a growing Applied Behavior Analysis (ABA) therapy organization serving families across New York City, Long Island, and Westchester County. We are hiring a Single Case Agreement (SCA) Specialist to expand our commercial insurance client base by negotiating case-by-case agreements with out-of-network payers, enabling more families to access the ABA services their children need. This is a mid-level, payer-facing role. You will own the full SCA lifecycle: identifying eligible referrals, negotiating reimbursement terms directly with insurance carriers, securing authorizations, and tracking agreement renewals. You will work closely with intake, billing, and clinical teams to ensure timely client access and compliant service delivery.

Requirements

2–4 years of experience in healthcare insurance coordination, payer relations, prior authorization, or a closely related function
Demonstrated ability to communicate and negotiate directly with commercial insurance carriers
Working knowledge of insurance benefit structures, prior authorization processes, and claims coordination
Experience in behavioral health, ABA, pediatric healthcare, or a Medicaid-adjacent multi-payer environment preferred
Familiarity with ABA CPT codes (97151–97158) is a plus
Strong organizational skills and the ability to manage multiple concurrent cases
Bachelor's degree in Healthcare Administration, Business, Social Work, or related field; equivalent experience considered
Bilingual English/Spanish a plus

Nice To Haves

Familiarity with ABA CPT codes (97151–97158) is a plus
Bilingual English/Spanish a plus

Responsibilities

Initiate and lead SCA negotiations with commercial insurance carriers for individual client cases
Evaluate referral insurance coverage and determine SCA viability before intake proceeds
Secure reimbursement rates, service authorization terms, and agreement durations that are financially sustainable
Coordinate prior authorization requests and track approval status for all SCA clients
Serve as the primary payer contact for SCA-related inquiries throughout the agreement lifecycle
Monitor renewal timelines and initiate extensions before agreement expiration
Maintain accurate documentation of all agreements, payer correspondence, rates, and authorization records
Communicate SCA status and timelines to families and referral sources throughout the process
Report on SCA pipeline activity, conversion rates, and revenue impact to HR Director and leadership
Ensure all SCA activity complies with New York State insurance regulations and organizational policy