ABA Billing Compliance Specialist / Claims Auditor

FantAutistic Skills Training (FAST) is a California-based Applied Behavior Analysis (ABA) agency seeking a detail-oriented professional to independently audit our billing team’s work and help ensure our claims and billing procedures align with insurance payer requirements.

We already have a billing team in place. This position focuses on reviewing their work, identifying errors and compliance concerns, and following through on corrections.

Responsibilities:

• Research insurance payer policies, provider manuals, and billing requirements, and monitor updates.
• Audit claims before and after submission for accurate billing codes, modifiers, units, dates of service, and provider information.
• Verify that billed services align with authorizations, provider credentials, and supporting session documentation.
• Identify duplicate claims, overlapping services, unsupported charges, and other potential discrepancies.
• Review denials, rejections, and payment discrepancies to identify recurring billing problems.
• Provide written audit findings with references to the applicable payer policies.
• Coordinate with our billing and clinical teams to resolve discrepancies and verify corrections.
• Develop and maintain payer-specific billing guides and staff checklists.
• Maintain patient confidentiality and follow company privacy and security procedures.

Qualifications:

• Previous experience in US medical billing, claims auditing, or billing quality assurance.
• Applied Behavior Analysis (ABA) billing experience strongly preferred.
• Ability to independently research and interpret payer-specific requirements.
• Strong attention to detail, written English, and organizational skills.
• Experience with Passage Health, Rethink, or Waystar is a plus.

This is a remote, part-time position starting at approximately 10 hours per week.

To apply, please provide:

1. A summary of your relevant billing and auditing experience, including ABA experience.
2. The US insurance payers and billing systems you have worked with.
3. An example of a billing error you identified and how you helped resolve it, without including patient information.
4. Your requested hourly rate and availability.

Shortlisted candidates may be invited to complete a brief paid skills assessment using fictional records.