Director of Billing - ABA

Spring Valley, NY

$140,000 - $175,000

The Director of ABA Billing oversees all revenue cycle operations for an Applied Behavior Analysis (ABA) practice, ensuring accurate, compliant, and efficient billing processes. This role leads billing teams, manages payer relationships, optimizes reimbursement, and ensures financial stability through strong oversight of claims, authorizations, and compliance with insurance and regulatory requirements.

Responsibilities:

Revenue Cycle Leadership

• Oversee the full ABA revenue cycle, including intake, authorizations, scheduling alignment, claims submission, payment posting, and collections.
• Develop and implement billing policies, workflows, and performance metrics to maximize clean claims and minimize denials.
• Lead, train, and mentor billing and authorization teams.

Insurance & Compliance

• Ensure all billing practices comply with federal, state, and payer-specific ABA requirements.
• Maintain up‑to‑date knowledge of CPT codes, modifiers, place-of-service rules, and payer policy changes.
• Conduct regular audits to ensure documentation and billing accuracy.

Claims Management

• Monitor claim submission timelines, rejection trends, and denial patterns.
• Oversee appeals and resubmissions to ensure timely reimbursement.
• Collaborate with clinical and administrative teams to resolve documentation or coding issues.

Authorization Oversight

• Ensure timely acquisition and renewal of authorizations for ABA services.
• Monitor utilization to prevent lapses in coverage or unauthorized services.

Financial Reporting

• Prepare and present revenue cycle performance reports, KPIs, and forecasting to executive leadership.
• Analyze financial trends and identify opportunities for improved cash flow and operational efficiency.

Cross‑Department Collaboration

• Partner with clinical directors, schedulers, and intake teams to ensure alignment between service delivery and billing requirements.
• Work with HR and training teams to educate staff on documentation and compliance standards.



Qualifications:

Required

• 5+ years of experience in medical billing, with at least 2–3 years in ABA or behavioral health.
• Strong knowledge of ABA billing codes (97151, 97153, 97155, 97156, etc.) and insurance requirements.
• Proven leadership experience managing billing teams.
• Expertise in revenue cycle management and payer relations.
• Proficiency with ABA practice management systems (e.g., CentralReach, Rethink, AccuPoint).

Preferred

• Bachelor’s degree in business, healthcare administration, or related field.
• Experience scaling billing operations in multi‑location or multi‑state ABA organizations.
• Familiarity with Medicaid, commercial insurance, and value‑based reimbursement models.