Spectrum Billing Solutions offers industry-leading revenue cycle management services for healthcare providers. Our team has deep industry knowledge, technology, and experience to ensure our client’s revenue cycle is managed in the most efficient and streamlined manner.

We are seeking to add an ABA Prior Authorization / UR Specialistto our growing team. The ABA Prior Authorization UR Specialist will utilize his or her knowledge and skills to review clinical information and obtain initial and continuing authorizations for ABA and related services. The ideal candidate is passionate, motivated, detail-oriented and interested in working in a cohesive and rewarding environment.

Looking for flexibility? We offer flexible options to work in-office, hybrid remote/in-office, or to work 100% fully remote.

Your Responsibilities:

Review patient admission and clinical information to ensure medical necessity and compliance of utilization review guidelines
Obtain initial and continuing authorization for treatment services
Manage authorization denials including referral for peer review
Document and record all necessary information
Monitor and track new and ongoing authorization cases
Collaborate and communicate with clinical staff to ensure necessary information is obtained and timely reviews are performed
Assist external clients in understanding payer requirements for authorizations
Participate in team meetings
Maintain confidentiality of patient information and adhere to HIPAA regulations

What we offer you:

Flexible work environment – You can work from home, hybrid or fully in office.
Competitive Salary – based on years of experience
A close-knit team of talented and skilled individuals
Growth opportunities – We are a growing company and want to promote within our team
Benefits – Medical, Dental, Vision
Flexible Paid Time Off – 3 weeks PTO time, which increases with your tenure
401K – with Company match
Supplemental Benefits

Qualifications:

3-5 years of related ABA and/or Behavioral Healthexperience
Bachelor’s or master’s degree preferred
Superior written and oral communication skills
Attention to detail to ensure necessary information is captured and properly documented
Ability to work independently and within a team
Ability to multi-task, prioritize and meet expected deadlines
Solid understanding of insurance benefits and coverages
Strong computer skills (Word, Excel, billing software)
Understanding of mental and behavioral health treatment services

Spectrum Billing Solutions

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ABA Prior Authorization / UR Specialist