Therapy and Beyond - ABA Therapy
Benefits and Authorization Specialist
Therapy and Beyond - ABA Therapy, Flower Mound, Texas, us, 75027
Company Description
Therapy & Beyond is one of the largest BCBA-owned ABA organizations, founded and led by Dr. Regina Crone, BCBA-D, since 2006. We approach each patient’s needs individually and as part of a dynamic interdisciplinary team that includes applied behavior analysis (ABA) therapists, speech-language pathologists, occupational therapists, and counselors. We love helping individuals reach their full potential by supporting not only the patient but also their family. We are passionate about what we do while remaining true to our defining core values:
Putting People First, Doing Our Best Together, Making Therapy Fun, and Above All, We Grow Potential .
Job Description The
Authorization and Benefits Specialist
is responsible for the full lifecycle of insurance verification and authorization. This role ensures financial reimbursement by securing pre-authorizations, obtaining retroactive approvals, and maintaining active authorizations for ongoing care. The specialist serves as a liaison between the organization, third-party payors, and clinical staff to prioritize efficiency.
Job-Specific Functions
Authorization Management: Initiate and secure initial benefits, pre-authorizations, and re-authorizations via payor portals, fax, or telephone.
Follow-Up & Tracking: Strictly adhere to follow-up schedules (e.g., 3, 7, 14, 30 days) based on payor guidelines to expedite claims and prevent revenue loss.
Complex Case Resolution: Manage high-complexity requests, including retroactive authorizations and Single Case Agreements (SCAs) for out-of-network patients.
Data Integrity: Verify that authorization quantities, CPT codes, and effective dates are accurately entered into the practice management system.
Clinical Collaboration: Coordinate directly with healthcare providers to secure necessary clinical notes, letters of medical necessity, and supporting documentation in a timely manner.
Process Improvement: Develop and maintain a centralized "Payor Master List" and internal authorization manuals to standardize workflows and improve efficiency.
Compliance: Review and interpret insurance group pre-certification requirements to ensure full compliance before services are rendered.
Qualifications
Education: Associate’s or Bachelor’s degree in Healthcare Administration or related field preferred.
Experience: Minimum of 2 years in insurance verification, medical billing, or authorization management.
Technical Skills: Proficiency with electronic medical records (EMR) systems and payor portals.
Soft Skills: Strong written and verbal communication, ability to build rapport with insurance representatives, excellent organizational skills, and attention to detail.
Additional Information
Generous benefit package:
Medical, Dental, Vision, and Disability
Company-paid Life Insurance
401(k) with company match
Company-paid Short-Term Disability
HSA and FSA options
Employee Assistance Program
Employee Recognition
Seniority level Not Applicable
Employment type Full-time
Job function Human Resources
Industries Mental Health Care
Locations
Frisco, TX ($76,400.00–$99,000.00)
Dallas, TX ($70,000.00–$95,000.00)
Denton, TX ($60,003.00–$69,712.00)
Dallas-Fort Worth Metroplex ($54.00–$60.00)
Southlake, TX ($95,000.00–$125,000.00)
Plano, TX ($85,000.00–$95,000.00)
Addison, TX ($80,000.00–$110,000.00)
Southlake, TX ($150,000.00–$190,000.00)
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Putting People First, Doing Our Best Together, Making Therapy Fun, and Above All, We Grow Potential .
Job Description The
Authorization and Benefits Specialist
is responsible for the full lifecycle of insurance verification and authorization. This role ensures financial reimbursement by securing pre-authorizations, obtaining retroactive approvals, and maintaining active authorizations for ongoing care. The specialist serves as a liaison between the organization, third-party payors, and clinical staff to prioritize efficiency.
Job-Specific Functions
Authorization Management: Initiate and secure initial benefits, pre-authorizations, and re-authorizations via payor portals, fax, or telephone.
Follow-Up & Tracking: Strictly adhere to follow-up schedules (e.g., 3, 7, 14, 30 days) based on payor guidelines to expedite claims and prevent revenue loss.
Complex Case Resolution: Manage high-complexity requests, including retroactive authorizations and Single Case Agreements (SCAs) for out-of-network patients.
Data Integrity: Verify that authorization quantities, CPT codes, and effective dates are accurately entered into the practice management system.
Clinical Collaboration: Coordinate directly with healthcare providers to secure necessary clinical notes, letters of medical necessity, and supporting documentation in a timely manner.
Process Improvement: Develop and maintain a centralized "Payor Master List" and internal authorization manuals to standardize workflows and improve efficiency.
Compliance: Review and interpret insurance group pre-certification requirements to ensure full compliance before services are rendered.
Qualifications
Education: Associate’s or Bachelor’s degree in Healthcare Administration or related field preferred.
Experience: Minimum of 2 years in insurance verification, medical billing, or authorization management.
Technical Skills: Proficiency with electronic medical records (EMR) systems and payor portals.
Soft Skills: Strong written and verbal communication, ability to build rapport with insurance representatives, excellent organizational skills, and attention to detail.
Additional Information
Generous benefit package:
Medical, Dental, Vision, and Disability
Company-paid Life Insurance
401(k) with company match
Company-paid Short-Term Disability
HSA and FSA options
Employee Assistance Program
Employee Recognition
Seniority level Not Applicable
Employment type Full-time
Job function Human Resources
Industries Mental Health Care
Locations
Frisco, TX ($76,400.00–$99,000.00)
Dallas, TX ($70,000.00–$95,000.00)
Denton, TX ($60,003.00–$69,712.00)
Dallas-Fort Worth Metroplex ($54.00–$60.00)
Southlake, TX ($95,000.00–$125,000.00)
Plano, TX ($85,000.00–$95,000.00)
Addison, TX ($80,000.00–$110,000.00)
Southlake, TX ($150,000.00–$190,000.00)
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