ABA Clinical Review Specialist

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

Benefits offered by this job

Health insurance

Paid time off

Retirement plan

Educational assistance

Corporate discounts

Job summary

Acentra Health is seeking a Behavioral Health Clinical Reviewer to conduct administrative and process-based reviews of ABA services. The BCBA Clinical Reviewer will evaluate documentation for medical appropriateness, ensuring compliance and completeness without direct clinical judgments.

Responsibilities include reviewing ABA services, ensuring timely accuracy, managing queues, and collaborating with supervisors to drive quality monitoring and process improvements. HIPAA policies apply.

Qualifications

• Master’s degree in psychology, Behavior Analysis, or a related field.
• 4–7 years of ABA experience and BCBA certification.
• Strong written and verbal communication and collaboration skills.

Responsibilities

• Conduct prospective, concurrent, and retrospective reviews of Behavioral Health services, with a focus on Applied Behavior Analysis (ABA).
• Evaluate age-appropriate testing, evaluation, and assessment tools to determine the appropriateness of ABA therapy.
• Ensure accuracy and timeliness of all review types in accordance with contract requirements.
• Monitor and manage daily workload and review queues, adjusting schedules as needed to meet departmental demands.
• Collaborate with the Supervisor on quality monitoring activities, identifying areas for improvement and supporting implementation efforts.
• Maintain current knowledge of review processes, clinical practices, and relevant guidelines.
• Serve as the first-line reviewer for ABA prior authorization requests, based on workload needs.
• Act as a liaison and resource for providers, addressing client/patient service issues and facilitating problem resolution.
• Foster positive, professional relationships with internal and external stakeholders to support effective review processes.
• Participate in training sessions and scheduled meetings to stay updated on review protocols and industry standards.
• Adhere to all corporate policies, including HIPAA Privacy and Security Rules.

Skills

Excellent written and verbal comms

Education

Master’s degree in psychology, Behavior Analysis, or related field

BCBA certification

Job description

Acentra Health is seeking a Behavioral Health Clinical Reviewer to conduct administrative and process-based reviews of ABA services. The BCBA Clinical Reviewer will evaluate documentation for medical appropriateness, ensuring compliance and completeness without direct clinical judgments.

Responsibilities include reviewing ABA services, ensuring timely accuracy, managing queues, and collaborating with supervisors to drive quality monitoring and process improvements. HIPAA policies apply.