Authorization & Revenue Cycle Coordinator

Position Summary

The ABA Authorization & Revenue Cycle Coordinator is responsible for ensuring all services across assigned centers are properly authorized, billed, and reimbursed in a timely and accurate manner. This role partners with clinical, intake, and billing functions to maintain continuity ofcare and revenue integrity.

This position supports two ABA centers and is accountable for preventing authorization gaps, reducing denials, and ensuring accurate claim flow.

Key Responsibilities

Authorizations Management

• Submit and track all initial and ongoing treatment authorizations (e.g., 97151, 97155, 97153)
• Monitor authorization status, approvals, and expirations
• Coordinate with BCBAs to ensure timely submission of assessments and treatment plans
• Maintain accurate authorization records in CentralReach (CR)
• Ensure no lapse in services due to expired or missing authorizations

Authorization Tracking & Compliance

• Maintain tracking of all active authorizations, including dates and approved units
• Proactively flag upcoming authorization expirations to clinical and operations teams
• Ensure required documentation is submitted to prevent delays or denials
• Track discrepancies between requested and approved services and escalate as needed
• Maintain organized, audit-ready records of all authorization activity

Claims & Billing Coordination

• Ensure all services are captured, converted, and submitted for billing
• Review and resolve claim rejections and denials
• Coordinate corrections with clinical and billing teams
• Track claims through full lifecycle (submission → adjudication → payment)

Denials & Follow-Up

• Investigate denial reasons and identify root causes
• Submit corrected claims or appeals in a timely manner
• Follow up with payors on outstanding claims and unpaid balances
• Maintain documentation of payer communications

Payor Coordination

• Verify insurance benefits and eligibility
• Communicate with Medicaid and commercial payors regarding authorizations and claims
• Resolve issues related to authorizations, credentialing discrepancies, and claim delays

Reporting & Collaboration

Provide weekly visibility into:

• Authorization status and upcoming expirations
• Claims status, denials, and AR follow-up
• Partner with BCBAs, Clinical Directors, Center Managers, and billing teams to ensure alignment
• Provide visibility into authorization limits that may impact scheduling, while clinical and operations teams maintain ownership of utilization management

Qualifications

• 1 years in medical billing, ABA billing, or revenue cycle management
• Experience with insurance authorizations (ABA/behavioral health preferred)
• Knowledge of ABA CPT codes (97151, 97153, 97155, etc.)
• Experience with Medicaid and commercial payors
• Strong attention to detail, organization, and follow-through
• Preferred: CentralReach (CR) experience; ABA setting experience