Job Description
Job Description
Position Overview
The Billing & Credentialing Coordinator is responsible for managing all billing, insurance authorizations, and provider credentialing activities for the ABA practice. This role oversees insurance billing workflows, payment reconciliation, authorizations, and provider credentialing to ensure accurate reimbursement, regulatory compliance, and uninterrupted client services.
The ideal candidate is highly organized, detail-oriented, and experienced in working with insurance payers, ABA service codes, and healthcare administrative systems.
Responsibilities
Billing & Revenue Cycle Management
- Submit and track insurance claims for ABA services (e.g., 97151, 97153, 97155, 97156)
- Monitor claim status, identify denials, and submit corrections or appeals
- Post insurance payments, adjustments, and write-offs accurately
- Reconcile Explanation of Benefits (EOBs/EOPs) against billed services
- Track and follow up on outstanding balances and underpayments
- Coordinate with families regarding patient responsibility
- Maintain accurate billing records in the practice management system
Authorizations Management
- Submit initial and ongoing authorization requests to insurance plans
- Track authorization dates, units, and utilization
- Communicate authorization changes to clinical and scheduling teams
- Prevent service lapses through proactive re-authorizations
- Maintain organized authorization documentation
Credentialing & Provider Enrollment
- Manage credentialing and re-credentialing for BCBAs, RBTs, and providers
- Submit provider enrollment applications to Medicaid and commercial payers
- Track credentialing status and renewal deadlines
- Maintain provider compliance files
- Serve as liaison with payers regarding credentialing issues
Administrative & Compliance Support
- Maintain HIPAA-compliant digital records
- Support audits and payer inquiries
- Collaborate with internal teams to resolve billing issues
- Assist with workflow and process improvements
- Perform other administrative duties as assigned
Requirements, Qualifications & Skills
- High school diploma or equivalent.
- Minimum 2 years of healthcare billing, authorizations, or credentialing experience
- Experience with Medicaid and/or commercial insurance
- Strong understanding of billing workflows and EOB reconciliation
- Excellent organizational and communication skills
- Proficiencywith EHR or practice management systems
- Experience in ABA or behavioral health (preferred)
- Familiarity with ABA CPT codes (preferred)
- Experience withCentralReachor similar platforms (preferred)
- Knowledge of Florida Medicaid (preferred)
Work Environment/Physical Demands
- The position is primarily based in an office setting within the ABA clinic. Mayprovidehybrid schedule opportunities.
- Requires prolonged periods of sitting, typing, and working on a computer.
- High levelof confidentialityrequired
- Time-sensitive responsibilities tied to billing and authorization deadlines