**Job Summary:**
The Collections and Billing Coordinator is responsible for managing and ensuring accurate billing, timely collections, and compliance with payer requirements for ABA services, MMA plans, and private insurance. This role involves working closely with insurance providers, clinical teams, and families to resolve billing issues and optimize reimbursement.
**Key Responsibilities:**
- Follow up on unpaid, denied, or underpaid claims with commercial and Medicaid payers.
- Analyze EOBs and remittance advice to identify discrepancies and resolve issues promptly.
- Prepare and submit claim corrections, reconsiderations, and appeals as needed.
- Communicate with insurance representatives and families regarding billing questions, balances, and coverage.
- Maintain accurate billing records in accordance with payer guidelines and company policies.
- Support month-end reporting related to accounts receivable and collections.
- Ensure compliance with HIPAA, payer contracts, and ABA billing regulations.
**Qualifications:**
- Proven experience (minimum of 1 year) in medical billing and collections, preferably within an ABA or behavioral health setting.
- Strong understanding of insurance billing processes, including EOBs, denials, and appeals.
- Experience working with Medicaid and commercial insurance plans.
- High attention to detail and strong organizational skills.
- Effective communication skills with both internal teams and external stakeholders.
- Ability to manage multiple accounts and priorities in a fast-paced environment.