Verification & Authorization Specialist (ABA Experience)

Spring Valley, NY

$70,000 - $90,000

The Eligibility & Authorization Specialist is responsible for verifying insurance coverage, securing authorizations, and ensuring ABA services are financially cleared before treatment begins. This role requires strong knowledge of ABA billing codes, payer rules, and documentation requirements.

Responsibilities:

• Verify insurance benefits for ABA services, including coverage details, cost‑share, and plan limitations.
• Confirm eligibility for ABA CPT codes
• Submit and track initial and ongoing authorizations for assessments and treatment.
• Monitor utilization of approved hours and notify teams when limits are approaching.
• Maintain accurate authorization records in the practice management system.
• Communicate with payers to resolve discrepancies and follow up on pending requests.
• Collaborate with BCBAs, intake, scheduling, and billing teams to ensure services align with authorized hours.
• Ensure compliance with payer requirements, documentation standards, and HIPAA.

Qualifications:

• 1–3 years of ABA authorization or eligibility experience.
• Strong understanding of ABA CPT codes and insurance requirements.
• Experience with systems like CentralReach, Rethink, or AccuPoint.
• Excellent communication, organization, and follow‑through.
• Ability to manage multiple deadlines in a fast‑paced environment.