Aba Billing Expert - 21116

Somewhere; Philippines; On-site; PHP 22,000 - 33,000; Full time

Job summary

Somewhere is seeking an experienced ABA Billing Expert to own end-to-end revenue cycle management for ABA services. The role emphasizes accurate claim submission, denial management, and authorization tracking to maximize collections.

The ideal candidate has 3–5 years of direct ABA billing experience, deep knowledge of CPTs, and proficiency with CentralReach or Rethink, along with payer portals such as Availity, Waystar, or Trizetto. Hybrid/onsite work in the Philippines is possible.

Qualifications

• Minimum 3–5 years of direct ABA billing and claims management experience.
• Must be able to independently manage end-to-end billing, VOBs, authorizations, and denial workflows from day one.
• Proven mastery of payer portals and clearinghouses; experience with ABA payers and Medicaid preferred.

Responsibilities

• Handle end-to-end ABA claims and revenue cycle from submission to posting of payments.
• Audit claims, follow up on denials, and perform clinical appeals as needed.
• Manage VOBs and authorizations; track renewals to prevent service interruptions.
• Ensure billing rules align with CPT codes and payer requirements.

Skills

ABA billing experience

End-to-end revenue cycle

Tools

CentralReach

Rethink

Availity

Waystar

Trizetto

Job description

ABA Billing Expert - 21116

Salary: ₱2,000 - 3,000 monthly

Company: Somewhere

Job Type: Full Time

Location: Philippines

Job Description

Job Title: ABA Billing Expert

Working Hours: M-F 9:00 AM to 5:00 PM EST

Salary Range: $2,000-$3,000 (final offer depends on the client based on your skills and experience)

About the Company: Provides in-home Applied Behavior Analysis (ABA) therapy services for children diagnosed with autism across Indiana and New Jersey.

We are seeking a seasoned, hands-on ABA Billing Expert with comprehensive end-to-end revenue cycle management experience in Applied Behavior Analysis (ABA). This is a high-impact, independent role for a professional who can fully own our billing operations, maximize collections, and resolve complex claim issues from day one with no training required.

Key Responsibilities

End-to-End ABA Claims & Revenue Cycle

• Submit clean primary, secondary, and tertiary ABA claims to commercial payers and Medicaid.
• Audit and monitor claims daily through clearinghouses and payer portals to ensure immediate clean-claim rates.
• Aggressively pursue unpaid, underpaid, rejected, or denied claims through routine follow-ups, corrected claims, and formal clinical appeals.
• Post ERA/EOB payments, balance client accounts, and verify accurate fee schedule rates.
• Apply deep operational knowledge of ABA CPT codes, including97151, 97152, 97153, 97154, 97155, 97156, 97157, and 97158.

VOB & Authorization Management

• Execute complete, start-to-finish ABA-specific Verifications of Benefits (VOBs), confirming deductibles, copays, out-of-pocket maximums, CPT code restrictions, hour limits, and telehealth guidelines.
• Submit and track initial authorizations and reauthorizations, ensuring alignment with diagnostic reports, BCBA treatment plans, and assessments.
• Maintain a proactive tracking system to renew authorizations prior to expiration and prevent service interruptions.

Systems & Operational Ownership

• Work seamlessly within industry-standard ABA practice management software (advanced experience withCentralReachand/orRethinkrequired).
• Collaborate with internal operations to ensure BCBA/RBT scheduling, session logs, and supervisory hours match billing rules and authorization constraints.
• Identify recurring payer trends, root-cause rejection patterns, and process bottlenecks to continuously improve internal RCM workflows.

Candidate Requirements

• Direct ABA Experience Required: A minimum of 3-5 years of dedicated, direct ABA billing and claims management experience. Generic medical billing or general healthcare experience alone is strictly insufficient.
• Zero-Training Expectation: Must be able to step into the role and independently manage end-to-end billing, VOBs, authorization tracking, and denial workflows on day one.
• Payer Mastery: Demonstrated success managing both commercial payers (Aetna, BCBS, Optum, Cigna, Humana, etc.) and state Medicaid programs.
• Technical Proficiency: Deep expertise using ABA platforms (CentralReach/Rethink), clearinghouses (Availity, Waystar, Trizetto), and payer portals.
• Proactive Drive: High level of autonomy, excellent organization, and an aggressive follow-through strategy with insurance reps to resolve unpaid claims.