ABA Authorization Specialist

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Behavioral Health Works, Inc.

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

👥 B2C

💰 Corporate round on 2019-02

Healthcare • B2C

Behavioral Health Works, Inc. is a provider of Applied Behavior Analysis (ABA) and individualized outpatient services for individuals with autism and other developmental disabilities. The company works collaboratively with families, schools, payers and other professionals to teach new skills and reduce harmful or disruptive behaviors, and also offers ancillary support services and assistance with funding. Headquartered in Garden Grove, CA, BHW operates in multiple U. S. states and emphasizes a care-team and community-focused approach.

📋 Description

• Submit, track, and manage initial, concurrent, and reauthorization requests for ABA therapy services. • Monitor authorization status and proactively follow up with insurance providers to ensure timely approvals and prevent interruptions in care. • Track authorization utilization and expiration dates, ensuring renewal requests are submitted within required timeframes. • Communicate authorization approvals, denials, modifications, and requests for additional information to internal stakeholders. • Collaborate with BCBAs and clinical teams to obtain treatment plans, assessments, progress reports, and supporting documentation required for authorization submissions. • Verify payer authorization requirements and maintain knowledge of commercial insurance, Medicaid, and managed care guidelines. • Assist with resolving authorization-related issues, denials, and appeals. • Maintain accurate authorization records and documentation within CentralReach and other company systems. • Ensure compliance with payer requirements, HIPAA regulations, and company policies. • Support authorization reporting, audits, workflow improvements, and other administrative functions as needed.

🎯 Requirements

• Associate's or Bachelor's degree in Healthcare Administration, Business Administration, Psychology, or a related field preferred. • Minimum of 2 years of experience in healthcare authorizations, insurance verification, utilization management, or a related healthcare administrative role. • Experience with ABA therapy authorizations strongly preferred. • Knowledge of insurance authorization processes, commercial payers, Medicaid, and managed care plans. • Proficiency with CentralReach, including the Authorizations Module. • Strong working knowledge of Google Workspace, including Google Sheets, Docs, Gmail, and Drive. • Exceptional organizational skills and attention to detail. • Excellent written and verbal communication skills. • Ability to manage multiple priorities and meet deadlines in a fast-paced environment.

🏖️ Benefits

• Flexible schedules • Health, Dental, Chiropractic, and Vision Insurance • Critical Illness, Voluntary Life, Accident, Hospital Confinement, and Basic Life Insurance • 401(k) • Pet Insurance Discounts • Paid Time Off • Seven Company-Paid Holidays • Professional Development Assistance • Employee Referral Program • Tuition Reduction for Partnered Universities, including National University, California Southern University, Vanguard University, Capella University, and Purdue Global