ABA Behavioral Health Compliance Reviewer

Acentra Health; United States; On-site; USD 39,000 - 54,000; Full time

Benefits offered by this job

Health benefits

PTO

Retirement savings

Wellness programs

Educational assistance

Job summary

Acentra Health is seeking a Behavioral Health Clinical Reviewer to join our team. This role conducts administrative and process-based reviews of ABA-related medical records to determine compliance and accuracy, without direct clinical judgments.

You will review prospective, concurrent, and retrospective cases, ensure timely documentation, and serve as the first-line reviewer for ABA prior authorization requests, collaborating with providers and internal stakeholders to uphold HIPAA guidelines.

Qualifications

• Requires BCBA certification/licensure in the State of Indiana.
• Master’s degree in psychology, Behavior Analysis, or another relevant field.
• Requires 4+ years' ABA or related clinical experience.
• Strong clinical assessment and critical thinking skills required.
• Knowledge of medical records organization and terminology.

Responsibilities

• Conduct prospective, concurrent, and retrospective reviews of ABA services.
• Evaluate age-appropriate testing, evaluation, and assessment tools for ABA therapy.
• Ensure accuracy and timeliness of all review types per contract requirements.
• Monitor and manage daily workload and review queues.
• Collaborate with the Supervisor on quality monitoring activities.

Skills

BCBA certification

ABA clinical experience

Medical records knowledge

Education

Master’s degree in psychology/Behavior Analysis

BCBA licensure/certification

Job description

Acentra Health is seeking a Behavioral Health Clinical Reviewer to join our team. This role conducts administrative and process-based reviews of ABA-related medical records to determine compliance and accuracy, without direct clinical judgments.

You will review prospective, concurrent, and retrospective cases, ensure timely documentation, and serve as the first-line reviewer for ABA prior authorization requests, collaborating with providers and internal stakeholders to uphold HIPAA guidelines.