Authorization Specialist (ABA, Speech, and OT)

Sunflower Development Center

Bridgewater, MA 02324, USA

Published: 6/14/2022

Education

Job Description

Now Hiring: ABA, Speech, and OT Authorization Specialist
Location: Raynham, MA (remote)
Company: Sunflower Development Center

Sunflower Development Center is a multidisciplinary pediatric therapy practice providing ABA, Speech, and Occupational Therapy to children in a warm, family-centered environment. We are seeking a detail-oriented and highly organized Authorization Specialist to manage insurance authorizations for all three service areas and support the clinical and administrative teams.

Position Overview:

The Authorization Specialist is responsible for handling all insurance authorization submissions, tracking approvals and expirations, verifying eligibility, and ensuring that services are fully authorized and billable. This role is essential to maintaining continuity of care and ensuring timely reimbursement.

Key Responsibilities:

Submit initial and ongoing authorizations for ABA, Speech, and OT services
Monitor and track authorization start/end dates and units across payers
Conduct daily eligibility checks or all active and incoming clients
Communicate with insurance companies to follow up on pending or denied requests
Collaborate with BCBAs, SLPs, and OTs to ensure required documentation is complete
Maintain accurate logs and reports in internal systems and payer portals
Support intake and billing teams by verifying benefits and prior auth requirements
Assist with appeals or resubmissions when authorizations are delayed or denied
Ensure compliance with payer guidelines, including MassHealth and commercial plans

Qualifications:

Prior experience in medical or therapy-related authorization or billing roles
Strong understanding of ABA, Speech, and OT authorization workflows
Familiarity with MassHealth, commercial payers, and managed care organizations
Excellent attention to detail and follow-through
Strong communication and problem-solving skills
Comfort using payer portals and EMR or practice management systems
Ability to work independently and prioritize multiple tasks
Knowledge of HIPAA and patient confidentiality standards

Preferred but Not Required:

Experience with Carelon, Mass General Brigham Health Plan, and Optum
Familiarity with ABA-specific billing codes (97151, 97153, etc.)

Schedule and Compensation:

part-time depending on candidate availability
In-person preferred for team collaboration
Competitive hourly rate based on experience
401k, paid sick time, and opportunity for growth within the organization

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