ABA Billing Specialist
hace 1 día
Louisville
Job Locations US-KY-LOUISVILLE ID 2026-187021 Line of Business SpringHealth Behavioral Health and Integrated Care Position Type Full-Time SpringHealth Behavioral Health and Integrated Care Join a team where your expertise directly drives financial accuracy and operational excellence. At SpringHealth Behavioral Health & Integrated Care, we are a clinically led organization committed to delivering high-quality, person-centered care-and our billing team plays a critical role in sustaining that mission. We are seeking an experienced ABA Billing Specialist who thrives in a fast-paced, detail-driven environment and takes pride in getting it right the first time. In this role, you will: Serve as a key owner of ABA billing accuracy across commercial payers and Medicaid • Act as a quality gatekeeper for claims, ensuring clean submissions and minimized denials, • Analyze billing trends, identify errors, and proactively drive corrective actions, • Partner cross-functionally with clinical, operations, and finance teams to resolve issues and improve processes, • Support strong gross collection performance and protect overall revenue integrity, • Monitor and manage denials, collections, and reporting with a high level of accountability, • Highly detail-oriented and analytical, with a strong sense of ownership, • Experienced in ABA billing and confident navigating payer requirements, • Comfortable working independently while driving cross-functional collaboration Key Responsibilities Quality Assurance & Oversight: • Perform ongoing quality audits of claims prior to and after submission to ensure accuracy, compliance, and payer-specific requirements are met., • Review claims for correct:, • CPT codes and modifiers (e.g., 97151, 97153, 97155, 97156, 97158,), • Provider credentials and supervision requirements, • Units, rates, authorizations, and service locations, • Diagnosis codes and payer-specific billing rules, • Identify billing trends, recurring errors, and systemic issues impacting claims, payments, or denials., • Review and analyze denials across commercial and Medicaid payers., • Identify root causes of denials and provide clear, actionable guidance to team leaders on how to prevent recurrence., • Support and oversee collections and follow-up efforts to ensure underpaid or denied claims are resolved appropriately., • Ensure claims are scrubbed and validated prior to submission to maximize first-pass acceptance., • Communicate findings clearly and professionally to team leaders, managers, and stakeholders., • Provide concise feedback on:, • What is incorrect, • Why is it incorrect, • What must be fixed, • How to prevent future errors, • Collaborate with credentialing, authorizations, and clinical documentation teams to resolve upstream issues impacting billing., • 5+ years of hands-on ABA billing experience, including both commercial payers and Medicaid., • In-depth knowledge of:, • ABA CPT codes and modifiers, • Authorization requirements, • Supervision and rendering provider rules, • State-specific Medicaid billing nuances, • Proven experience working with denials, appeals, collections, and payer follow-ups., • Strong understanding of revenue cycle metrics, including GCR and A/R management., • Exceptional attention to detail - consistently catches errors others miss., • Highly self-motivated - able to manage workload independently and prioritize effectively., • Clear and confident communicator - able to give direct, professional feedback to team leads and stakeholders., • Analytical mindset - able to identify trends, root causes, and data-driven solutions., • High accountability - takes ownership of outcomes and revenue integrity., • Process-driven - values structure, documentation, and consistency. Success in this role is measured by: • Reduced claim error rates and denials, • Improved first-pass acceptance rates, • Timely identification and correction of billing issues, • Clear, actionable communication with team leads