- Review, validate, and submit ABA therapy claims using CentralReach and applicable clearinghouse systems.
- Process the assigned billing backlog while meeting established productivity expectations.
- Verify client demographics, authorizations, provider credentials, CPT codes, units, dates of service, and place-of-service requirements.
- Identify documentation issues that prevent claims from being submitted and coordinate corrections or addendums with BCBAs, Clinical Directors, and other providers.
- Review claims for payer-specific billing requirements and help prevent duplicate billing and authorization utilization errors.
- Review rejected, held, or otherwise unsubmitted claims; research rejection reasons, correct errors, and resubmit claims when appropriate.
- Identify and escalate recurring billing barriers or trends, and document follow-up activity and claim resolutions.
- Track daily claim submission volume and backlog reduction progress and provide regular project status updates to Revenue Cycle leadership.
Microsoft ExcelHIPAA