Billing & Accounts Receivable Specialist- ABA Therapy

Job Summary

Integrity Learning Center is seeking a detail-oriented, proactive ABA Billing Specialist to manage day-to-day billing operations for Applied Behavior Analysis (ABA) therapy services.

This position is responsible for the full billing cycle, including claim preparation and submission, primary and secondary billing, accounts receivable (AR), denial resolution, payer follow-up, and reimbursement tracking.

The ideal candidate has experience with ABA billing, understands Medicaid and commercial insurance requirements, and can independently identify and resolve billing issues while maintaining accurate records and timely reimbursement.

The Billing Specialist works closely with clinical, administrative, and leadership teams to ensure billing practices are accurate, efficient, and compliant with applicable requirements.

What Success Looks Like

Success in this role means taking ownership of assigned claims from submission through final resolution. The Billing Specialist consistently submits accurate claims, proactively follows up on outstanding balances, reduces aging AR, resolves denials promptly, and prevents avoidable reimbursement delays.

The successful candidate is organized, resourceful, communicates clearly, and independently manages daily priorities while keeping leadership informed of progress, challenges, and opportunities for improvement.

Key Responsibilities

ABA Billing & Claims Management

• Manage daily billing operations for assigned ABA therapy services.
• Prepare, review, and submit accurate insurance claims within required timelines.
• Verify CPT codes, modifiers, units, rendering providers, authorizations, place of service, and payer-specific billing requirements.
• Complete corrected claims, resubmissions, and other necessary claim adjustments.
• Maintain accurate insurance, claim, and billing information within applicable systems.
• Ensure claims accurately reflect documented services and comply with applicable billing requirements.

Accounts Receivable & Denial Management

• Independently manage AR follow-up, including aging claims and outstanding balances.
• Investigate and resolve rejected, denied, unpaid, and underpaid claims.
• Complete payer follow-up, reconsiderations, appeals, and timely filing disputes as appropriate.
• Prioritize claims based on aging, payer deadlines, and reimbursement opportunities.
• Track claims through final resolution and document all actions taken.
• Identify recurring denial patterns and recommend solutions to improve billing efficiency.

Primary & Secondary Insurance Billing

• Manage primary and secondary claim submissions and follow-up.
• Review and submit required Explanation of Benefits (EOB) and remittance information.
• Investigate coordination-of-benefits issues and secondary payer denials.
• Monitor secondary claims through payment or other documented resolution.

Payer Requirements & Documentation

• Complete and track Notices of Benefit (NOBs), when required, and other payer-specific documentation.
• Monitor authorization, provider enrollment, and billing requirements affecting claim reimbursement.
• Coordinate with clinical and administrative teams to resolve documentation or billing discrepancies.
• Maintain accurate billing records and claim follow-up documentation.

Communication & Collaboration

• Communicate professionally with insurance representatives, families, and internal team members regarding billing concerns.
• Work collaboratively with clinical and administrative teams to resolve issues affecting reimbursement.
• Provide leadership with clear updates on completed work, AR progress, unresolved claims, and barriers requiring assistance.
• Escalate recurring billing issues and recommend process improvements.

Compliance & Accuracy

• Follow applicable HIPAA requirements, company policies, payer guidelines, and federal and state billing regulations.
• Maintain accurate and complete billing documentation to support audits and reimbursement.
• Identify potential billing discrepancies and take appropriate corrective action.
• Support ethical billing practices and prevention of fraud, waste, and abuse.

Qualifications & Requirements

Required Qualifications

• High school diploma or equivalent.
• Experience in medical billing, insurance claims processing, or healthcare revenue cycle management.
• Knowledge of CPT codes, insurance terminology, claim submission, denials, and accounts receivable processes.
• Strong organizational skills, attention to detail, and ability to manage multiple priorities.
• Proficiency in billing software and Microsoft Office, particularly Excel.
• Strong communication, research, and problem-solving abilities.
• Ability to independently manage assigned billing responsibilities and consistently follow through to resolution.

Preferred Qualifications

• Direct experience with ABA therapy billing and revenue cycle management.
• Experience with Indiana Medicaid and managed care organizations, including Anthem, CareSource, MHS, and UnitedHealthcare.
• Experience with commercial insurance payers
• Experience managing aging AR, complex denials, corrected claims, and appeals.
• Familiarity with ABA CPT codes, modifiers, authorizations, and provider credentialing requirements.
• Associate’s or bachelor’s degree in healthcare administration, accounting, finance, or a related field.

Ideal Candidate

We are looking for someone who takes initiative, follows through, and approaches billing challenges with a solution-focused mindset. The ideal candidate does not simply identify billing problems but actively researches, corrects, and resolves them.

This person is comfortable working independently, maintaining accountability for assigned responsibilities, and communicating progress without requiring constant oversight.

Our goal is to maintain a billing process that is accurate, compliant, organized, and efficient so our clinical teams can remain focused on providing quality care.