ABA Compliance Specialist - Remote Fridays & Billing Training

Gemma Services; Philadelphia (Philadelphia County); On-site; USD 55,000 - 75,000; Full time

Benefits offered by this job

Paid time off

Medical, dental, vision benefits

Tuition reimbursement

403B with employer match

Wellness funds

Remote Fridays

Job summary

Gemma Services operates an ABA program from its Mt. Airy location, delivering services in schools, homes, and community settings. The role focuses on auditing billable notes, ensuring compliance with OMHSAS CBH standards, and supporting staff with documentation and billing processes.

The ideal candidate has a bachelor’s degree in a related field and at least three years of PA Medicaid behavioral healthcare experience, including claims processing and EHR usage.

Qualifications

• Bachelor’s degree in psychology, sociology, social services, or related field.
• Minimum 3 years experience in PA Medicaid behavioral healthcare and billing.
• Experience with claims processing and fiscal/billing workflows.

Responsibilities

• Audit and monitor billable notes prior to claim submission.
• Provide compliance training for staff to meet licensing standards.
• Provide real-time support to staff on notes, documentation, and billing.
• Recommend workflow improvements and conduct verification calls to families and schools.
• Ensure knowledge of local, state, and federal regulations for IBHS and ABA programs.
• Collaborate with fiscal department to resolve held/denied/ rejected claims.
• Maintain CBH data entry for authorizations in the EHR.
• Monitor MCO authorizations and communicate Medicaid eligibility.

Skills

Reading & writing

Interpersonal skills

EHR systems

Education

Bachelor's degree in psychology or related field

Tools

Electronic Health Records

Microsoft Office

Database management

Job description

Gemma Services operates an ABA program from its Mt. Airy location, delivering services in schools, homes, and community settings. The role focuses on auditing billable notes, ensuring compliance with OMHSAS CBH standards, and supporting staff with documentation and billing processes.

The ideal candidate has a bachelor’s degree in a related field and at least three years of PA Medicaid behavioral healthcare experience, including claims processing and EHR usage.