Aba Authorization And Financial Consultation Specialist (Remote Position)

Remote Opportunity

What does a Authorization and Financial Consultation Specialist Do?

Little Leaves provides full insurance support to families who seek our services. The Authorization and Financial Consultation Specialist will work closely with families to ensure they understand and can fully access their insurance benefits for our ABA services, and that they understand and have a plan for their costshare responsibilities. This role will obtain theauthorization from insurance plans that is required for almost services delivered by Little Leaves. The ideal candidate will understand that this position plays a critical role in helping families of children with special needs obtain the high-quality services that their children deserve.The candidate will bring the same attention to detail and tenacity to the insurance team as we bring to treating the children.

What are the benefits?

• Pay $55,000
• Generous benefits, including health, dental, vision, retirement, paid time off, life and disability insurance

Responsibilities

• Responsible for the timely verification of insurance benefits provided via websites and/or calling the payor.

• Responsible for updating patient Billing Episodes and crediting account, as appropriate.

• Obtain precertification and authorizations for services being rendered.

• Review and resolves prior authorization/precertification/referral issues that are not valid and contacts insurance carriers to verify/validate requirements to ensure accuracy and avoid potential denial.

• Validates all necessary referrals/prior authorizations/pre-certifications for scheduled services are on file and shared with all appropriate staff and are valid for the scheduled services performed.

• Validate financial counseling with onboarding clients, determining financial responsibility and handbook review on charges that can be applied.

• Ensure all account activity is documented in the appropriate system and shared with all appropriate staff timely and thoroughly.

• Remain knowledgeable about funding options, including Affordable Care Act options and grants, that may help families access services.

• Serve as primary resource for inquiries with questions about insurance coverage and benefits for ABA.

• Conduct Financial Consultation conversations with all clients to review financial agreements and out of pocket expenses.

• Advise current client families who are exploring insurance plan changes to ensure new options meet child’s coverage needs.

• Troubleshoot and resolve problems related to coverage.

• Develop expertise in ABA insurance coverage, authorizations, and relevant state and federal laws.

• Develop a familiarity with ABA-related code set and how services are billed at Little Leaves.

• Remain current on payor policies related to authorizations.

• Submit and follows-up on requests for prior and concurrent authorization in a timely manner.

• Serves as a liaison with the clinical team when clinical information and review is required.

• Develop and maintain resources to support clinical team’s participation in the authorization process.

• Independently manage timelines and due dates for all client authorizations.

• Troubleshoot and resolve problems related to service authorizations.

• Work with billing and AR team to problem solve issues in claims payment resulting from issues pertaining to client authorizations and policy changes.

• Maintain reports to ensure all deadlines are met.

• Performs other duties as assigned.

Desired Qualifications

• Bachelor’s degree preferred; High school diploma/GED required

• Prior relevant experience in intake, benefits checks and prior authorizations within healthcare

• Highly organized and detail oriented; strong communication and interpersonal skills

• Customer-service / problem-solving orientation

• Proficiency with Excel; technologically adept

• Clear oral and written communication

• Ability to problem solve and work independently

About Us

Little Leaves Behavioral Services provides high quality, critical early intervention programs designed to nurture the growth and development of young children with social, behavior, and/or language challenges. Little Leaves provides a range of in-home, at-school, and clinic-based ABA services for children with developmental delays, especially Autism Spectrum Disorders in Northern VA, the DC metro area, the Baltimore metro area and Ft Lauderdale area in FL.

The Little Leaves is a center-based ABA program for young children with an Autism Spectrum Disorder run in a preschool-like setting. The Little Leaves Center Program runs Monday through Friday from 8:30 am - 5 pm. During the day, children have the opportunity to participate in individual therapy time, small group activities with peers, and activities of daily living. While many clients are at Little Leaves for the full day, an individualized schedule is developed for each child based on his/her therapeutic needs.

We are a professional organization with a powerful social objective: to become a national leader in programs for children with autism and unique learning needs. Little Leaves is a division of FullBloom, Impact for Life.

For more information, please visit www.littleleaves.org

Little Leaves and FullBloom are Equal Opportunity Employers