Therapy and Beyond - ABA Therapy ยท 4 days ago
Benefits and Authorization Specialist
Flower Mound, TX
Full-time
Onsite
Entry, Mid Level
2+ years expTherapy & Beyond is one of the largest BCBA-owned ABA organizations, dedicated to helping individuals reach their full potential through a collaborative approach. The Benefits and Authorization Specialist is responsible for managing insurance verification and authorization processes, ensuring financial reimbursement while collaborating with clinical staff and third-party payors.
Child CareHealth CareTherapeuticsWellness
Responsibilities
Authorization Management: Initiate and secure initial benefits, pre-authorizations, and re-authorizations via payor portals, fax, or telephone
Follow-Up & Tracking: Strictly adhere to follow-up schedules (e.g., 3, 7, 14, 30 days) based on payor guidelines to expedite claims and prevent revenue loss
Complex Case Resolution: Manage high-complexity requests, including retroactive authorizations and Single Case Agreements (SCAs) for out-of-network patients
Data Integrity: Verify that authorization quantities, CPT codes, and effective dates are accurately entered into the practice management system
Clinical Collaboration: Coordinate directly with healthcare providers to secure necessary clinical notes, letters of medical necessity, and supporting documentation in a timely manner
Process Improvement: Develop and maintain a centralized "Payor Master List" and internal authorization manuals to standardize workflows and improve efficiency
Compliance: Review and interpret insurance group pre-certification requirements to ensure full compliance before services are rendered
Qualification
Required
Minimum of 2 years of experience in insurance verification, medical billing, or authorization management
Proficiency with electronic medical records (EMR) systems, and payor portals
Strong written and verbal communication skills with the ability to build rapport with insurance representatives
Excellent organizational skills and attention to detail
Preferred
Associate's of Bachelor's degree preferred in Healthcare Administration or related field preferred
Benefits
Medical, Dental, Vision, and Disability
Company Paid- Life Insurance
401K with company match
Company Paid Short-Term Disability
HSA and FSA options
Employee Assistance Program
Employee Recognition
Company
Therapy and Beyond - ABA Therapy
Therapy and Beyond provides individualized ABA, Speech and Occupational Therapy for individuals with autism and other developmental disabilities in Texas and Oklahoma.
201-500 employees
Funding
Current Stage
Growth StageLeadership Team
Dr. Regina Crone
Founder and President
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