INTERNAL ONLY Medical Necessity Specialist jobs in United States
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Action Behavior Centers - ABA Therapy for Autism · 8 hours ago

INTERNAL ONLY Medical Necessity Specialist

Action Behavior Centers is a leading development organization for children with autism based out of Austin, Texas. They are looking for an assertive and driven clinical professional to join their team in a crucial administrative role to support the Vice President of Clinical Services and other leaders in managing time-sensitive documentation and insurance communications.

Health Care
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Growth Opportunities

Responsibilities

Assisting Regional Autism Advocate(s) in campaigning to insurance companies on patient services
Review and confirm patient intake paperwork
Review & proof read patient reports provided by BCBAs and prepare patient documents for insurance authorization requirements
Manage & upkeep patient paperwork in SalesForce
Participate in meetings with the Corporate Team
Maintain patient communication with the Office Managers across all ABC locations
Assist Regional Autism Advocate(s) and Director of Clinical Advocacy and Authorizations with Ad Hoc projects. This may also be inclusive of Ad Hoc projects from our Vice President of Clinical Services
Oversees and maintains the company's healthcare data entry procedures within HIPAA compliance guidelines
Confirm authorization via phone calls, and enter authorization documents quickly and accurately
Confirm, maintain and enter patient's healthcare and authorization information with sensitivity and discretion into the EMR/billing system
Fax and submit for authorization of treatment
Schedule Peer-to-Peer (P2P) calls for insurance companies; This includes scheduling P2P calls for our BCBAs regarding general or specific clinical case discussions, etc
Account for submission and resubmission to new insurance companies with updated paperwork

Qualification

Registered Behavior Technician (RBT)Applied Behavior Analysis (ABA)SalesForceInsurance negotiationCommunicationDetail orientedOrganizational skills

Required

Registered Behavior Technician (RBT) required
Working knowledge and understanding of Applied Behavior Analysis (ABA) therapy is strongly recommended
Previous experience negotiating with insurance companies
A strong, pleasant personality with a high EQ
Extremely detail oriented – you minimize mistakes because you care about how your work affects patients
Assertive and strong communication style - you know how to get what you want because you can eloquently present the facts and advocate for patient services
You possess a high-level of organizational skills - you rarely drop the ball because you love having systems in place to keep things running smoothly
You like to work really hard – you aren't watching the clock for quittin' time because there is always more than needs to be done, and you like that

Preferred

An RBT with 2+ years of clinical experience is preferred
Familiarity with SalesForce is recommended but not required
Undergraduate is ideal but not required

Benefits

10 Days of PTO, 10 Paid Holidays, 2 Flex Days + More with Tenure
Student Loan Repayment Employer Contributions
Maternity/Paternity Award of up to $3,000 & FSA Options for Childcare
Door Dash Pass and Regional Night of Honors
Up to $600 Student Loan Repayment Options & Tuition Discounts
Professional development: we want to pour into you as you pour into ABC
Leadership opportunities: To be the best, we have to continually keep learning and you get to push yourself here to learn more and take on more responsibilities, and show what you can do!
401K Retirement Plans with company matching

Company

Action Behavior Centers - ABA Therapy for Autism

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At Action Behavior Centers (ABC), we help children diagnosed with autism spectrum disorder (ASD) reach milestone moments.

Funding

Current Stage
Late Stage
Total Funding
unknown
2023-06-01Debt Financing
2022-08-17Acquired

Leadership Team

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Hersh Sanghavi
Chief Executive Officer and Board Director
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H
Holly Lambert
Co-Founder
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Company data provided by crunchbase