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Billing & Credentialing Specialist
Billing & Credentialing SpecialistNorth Arrow ABA • Traverse City, MI, US
Billing & Credentialing Specialist

Billing & Credentialing Specialist

North Arrow ABA • Traverse City, MI, US
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Job Description

Job Description

Salary : $21-$22 Hourly

North Arrow ABA provides high-quality applied behavior analysis (ABA) therapy services to children and families. We are committed to excellence in care, compliance, and integrity. To support our growing team, we are seeking a Billing & Credentialing Specialist to ensure the accuracy and compliance of clinical documentation and claims submission.

  • Remote, but MUST be within 45 minutes of Traverse City, Mi

Position Overview :

This position is responsible for ensuring accuracy, compliance, and efficiency across clinical documentation, billing processes, and contractual requirements within the organization. This position plays a key role in maintaining high standards of service delivery, safeguarding compliance with payer and regulatory guidelines, and supporting staff accountability through documentation audits. This role requires strong attention to detail, knowledge of ABA service delivery and healthcare billing practices, and the ability to communicate findings in a clear, professional manner.

Key Responsibilities :

  • Audit ABA therapy session notes, treatment plans, and supporting documentation for compliance, accuracy, and clinical integrity.
  • Ensure documentation meets insurance payer, Medicaid, HIPAA, and organizational standards.
  • Identify and correct documentation deficiencies; provide feedback to staff on errors and compliance concerns.
  • Prepare and submit insurance claims promptly and accurately.
  • Track claim submissions, rejections, and denials; follow up with payers as needed to ensure resolution.
  • Maintain audit logs and reports to track compliance trends and identify areas of improvement.
  • Stay up to date with payer policies, ABA billing codes, and compliance requirements.
  • Collaborate with clinical and administrative leadership to provide feedback, identify areas for improvement, and recommend corrective action plans.
  • Support quality improvement initiatives that promote operational excellence, regulatory compliance, and effective service delivery.
  • Administrative Job-Specific Tasks :

  • Assist the Director of Administration (DoA) and the Authorization Specialist in the management and coordination of ongoing client authorizations.
  • Enters and updates information in the electronic health record to ensure consistency with documentation.
  • Compile and abstract data from medical records.
  • Maintains the confidentiality of all company procedures, results, and information about participants, clients, or families.
  • Must be able to analyze medical record documentation to determine outcomes of services, status type, and medical records that are associated with the related duration of services.
  • Supports other roles in the integrity of health and financial information within the electronic medical record.
  • Other duties as requested / assigned.
  • Qualifications and Requirements :

  • Bachelors degree in Healthcare Administration, Business Administration, or related field preferred.
  • Prior experience in revenue cycle management within a healthcare or ABA setting is strongly preferred.
  • Proficiency in billing software and electronic health records (EHR) systems; knowledge of the Central Reach billing platform desired.
  • Knowledge of insurance procedures, billing codes (CPT, ICD-10), and reimbursement guidelines relevant to ABA services.
  • Detail-oriented with strong organizational and analytical skills.
  • Excellent written communication and interpersonal skills to effectively collaborate with team members, clients, and insurance providers.
  • Ability to prioritize tasks, meet deadlines, and adapt to changing priorities in a fast-paced environment.
  • Skilled in preparing and maintaining records, writing reports, and responding to correspondence.
  • Skilled at locating specific data in medical records.
  • Must submit to and pass a pre-employment screening and criminal background check.
  • Operates in full compliance with all applicable federal, state, and local laws and standards;
  • Reliable transportation for occasional in-office functions
  • What We Offer :

  • Remote, flexible work environment.
  • Opportunities for professional growth and training.
  • Supportive team focused on quality and compliance.
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    Credentialing Specialist • Traverse City, MI, US

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