Revenue Cycle Management (RCM) Billing Specialist

Job Description

Job DescriptionDescription:

About Children’s Specialized ABA

Children’s Specialized ABA is part of the Children’s Specialized Hospital Autism Center of Excellence. We serve children with ASD by combining clinical innovation, whole-child care, and personalized therapy.?

At Children’s Specialized ABA, we envision a future where every child diagnosed with autism has access to innovative and compassionate care, empowering them to thrive and reach their full potential. Our vision is built on four core values:

• Inclusivity: We celebrate the diversity within the Autism spectrum and are committed to creating an inclusive environment that respects and values each person’s individual strengths and differences.
• Innovation: We foster a culture of creativity and collaboration, exploring new ideas to develop personalized solutions that enhance quality of life for all children with Autism.
• Connection: We actively engage with the health systems and broader community to coordinate services and care for people with Autism.
• Quality and Safety: We invest in research and training to provide cutting-edge, effective, safe, and personalized services tailored to the unique needs of those we serve.

Join Us as a RCM Billing Specialist!

The RCM Billing Specialist is responsible for the accurate and timely submission of multidisciplinary healthcare claims, with a primary focus on Applied Behavior Analysis (ABA) services. This position plays a critical role in ensuring claims are billed efficiently through CentralReach and Waystar, while maintaining compliance with payer requirements and organizational billing standards. This role reports to the RCM Billing Manager.

The ideal candidate will possess strong healthcare billing experience, demonstrate proficiency within CentralReach, and have the ability to identify, communicate, and help resolve billing issues in collaboration with Revenue Cycle Management leadership.

What You'll Do:

Claims Submission

• Submit weekly batches of primary claims for ABA and other multidisciplinary services through CentralReach and Waystar.
• Review claims for completeness, accuracy, and compliance prior to submission.
• Ensure timely filing requirements are met for all assigned payers.
• Monitor claim submission reports and address any rejections or submission errors collaborating with management on any issues or trends.

Secondary Claims Processing

• Prepare and submit secondary claims accurately and timely.
• Verify primary claim adjudication and coordinate benefits requirements prior to submission.
• Maintain documentation supporting secondary claim submissions.

Billing Operations Support

• Work closely with the RCM Billing Manager to identify and communicate:
• Billing issues
• Claim submission barriers
• Outstanding claim items
• Escalations requiring leadership review
• Participate in workflow discussions and process improvement initiatives.
• Maintain organized tracking of claim submission activities and follow up items.

Claim Corrections and Adjustments

• Process corrective claims as directed by the RCM Manager or Director.
• Submit void and replacement claims when requested by Quality Assurance (QA), Compliance, or Revenue Cycle leadership.
• Assist with claim correction projects and payer specific billing requirements.

Compliance and Quality

• Follow all company policies, payer guidelines, and regulatory requirements.
• Maintain accurate documentation of billing activities.
• Support internal audits and quality reviews as requested.
• Ensure confidentiality and protection of protected health information (PHI) in accordance with HIPAA regulations.

What You'll Need

Required Qualifications

• Minimum of 1 year of hands-on experience using CentralReach for healthcare billing.
• Minimum of 2 years of medical billing experience, preferably within ABA, behavioral health, therapy, or multidisciplinary healthcare services.
• Experience utilizing claim clearinghouses such as Waystar.
• Knowledge of insurance billing fundamentals, claim submission processes, and payer requirements.
• Strong attention to detail and organizational skills.
• Ability to manage multiple priorities and meet deadlines in a fast-paced environment.
• Proficiency in Microsoft Excel, Outlook, and other standard business applications.
• Strong written and verbal communication skills.

Preferred Qualifications

• 3+ years of CentralReach billing experience.
• ABA billing experience.
• Experience with multidisciplinary billing environments including behavioral health, speech therapy, occupational therapy, physical therapy, or related services.
• Experience processing secondary claims, corrective claims, and void/replacement claims.
• Familiarity with Medicaid, commercial insurance, and managed care payer billing requirements.
  

Work Location & Hours:

This position may be performed remotely or in a hybrid environment based on business needs. Availability expected between 8:30am - 5:00pm EST. Must reside in one of the following states: FL, IL, IN, MD, MI, MO, NC, NY, OH, PA, TX, or VA

Candidates must maintain reliable internet access and be able to work independently while collaborating effectively with team members and leadership.

Why Work With Children’s Specialized ABA?

We’re an amazing ABA provider! We take a whole-child, whole-caregiver approach. Our integrated model combines ABA therapy with speech, occupational therapy, and behavioral health support. You’ll be part of a deeply collaborative, mission-driven team.

Here’s what you can expect:

• Up to 19 paid days off in your first year (including PTO, sick time, and holidays); earned on an accrual basis, paid time off increases with tenure
• Comprehensive benefits including FREE medical (for employee, buy-up for dependent/partner coverage), voluntary dental, vision, short-term disability, critical illness coverage, and more!
• Free 50k life insurance policy.
• Free Employee Assistance Program (EAP).
• 401(k) retirement savings plan
• Company discount program – discounts off amusement parks, memberships, cruises, movie tickets, spas, sports ticks and more.

Compensation

The expected salary range for this role is $24.00 - $28.00 per hour.

Final compensation will be based on a range of factors, such as your skills, education, experience, certifications, market conditions, and internal equity. All offers are made in alignment with applicable federal and state laws.

Children’s Specialized ABA provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.

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Requirements: