Senior ABA Revenue Cycle / Accounts Receivable Specialist

Remote | US Hrs

Apply here: https://operationsarmy.com/application

Job Overview

We are seeking an experienced Senior ABA Revenue Cycle / Accounts Receivable Specialist to take ownership of day-to-day revenue cycle management (RCM), insurance claims, denial management, and accounts receivable operations.

The ideal candidate has strong hands-on experience in healthcare revenue cycle management, with a deep understanding of medical billing, insurance claims, denial resolution, payer follow-ups, and collections. Direct experience in Applied Behavior Analysis (ABA) billing is highly preferred due to the specialized billing requirements and payer-specific rules involved.

This position requires a proactive, independent, and highly accountable professional who can identify denied and aging claims, investigate outstanding issues, and drive them through resolution without waiting for assignments. The successful candidate should be comfortable managing high-volume accounts receivable work, identifying recurring denial patterns, and implementing solutions to prevent future billing issues.

Beyond day-to-day claims management, this role will contribute to improving billing processes, strengthening operational controls, and identifying opportunities for automation. This is a senior, hands-on position that requires meaningful RCM experience and independent problem-solving capabilities, rather than basic medical billing, data entry, or medical document retrieval experience.

Key Responsibilities

1. Revenue Cycle Management & Accounts Receivable

Own and manage day-to-day healthcare revenue cycle management and accounts receivable responsibilities, with a primary focus on high-volume claims and denial management.
Proactively monitor denied, outstanding, and aging claims within billing systems to identify issues requiring immediate attention.
Independently review claim queues and identify outstanding items without waiting for assignments or instructions.
Investigate claim statuses through insurance payer portals and billing systems, ensuring timely follow-ups and resolution.
Manage outstanding receivables through consistent payer follow-ups, collections activities, and appropriate escalation of unresolved claims.
Prioritize claims based on aging, urgency, financial impact, and applicable filing or resubmission deadlines.
Maintain accurate documentation of claim investigations, follow-ups, corrective actions, and resolution statuses.

2. Claims Investigation & Denial Management

Investigate denied and rejected claims to determine the reasons for nonpayment or processing delays.
Identify root causes of denials and determine the appropriate corrective actions.
Correct billing errors, prepare and submit corrected claims, and manage claim resubmissions within applicable payer deadlines.
Follow up directly with insurance companies to resolve claim discrepancies, payment issues, and outstanding balances.
Monitor recurring denial patterns and identify underlying issues affecting claim acceptance and reimbursement.
Escalate complex billing issues when necessary and ensure they are followed through until resolution.
Help minimize preventable denials, reduce outstanding AR balances, and improve overall reimbursement turnaround times.

3. ABA Billing & Payer Compliance

Apply a strong understanding of ABA-specific billing requirements, reimbursement guidelines, and insurance payer policies.
Navigate payer-specific billing rules, particularly concurrent billing restrictions involving supervision services and direct care provided by Registered Behavior Technicians (RBTs).
Identify potential conflicts involving service dates, times, provider documentation, and billing combinations that may result in claim denials.
Review potential ABA billing discrepancies and proactively identify issues before claims are submitted.
Ensure billing activities align with applicable payer-specific requirements and reimbursement policies.
Stay informed about payer rules and billing requirements that may affect ABA claims processing and reimbursement.

4. Process Improvement & Automation

Identify recurring claim denials, billing discrepancies, and operational bottlenecks.
Analyze denial trends and recommend preventative measures to reduce repeated billing issues.
Collaborate with the team to develop and improve billing workflows, internal controls, and operational processes.
Identify opportunities to streamline repetitive RCM tasks through automation and technology.
Help develop proactive processes that catch potential billing issues before claims are submitted.
Contribute to improving claims resolution turnaround times, billing accuracy, collections effectiveness, and overall AR performance.

5. Team Collaboration & Operational Ownership

Work closely with the existing RCM team to coordinate responsibilities and distribute workloads based on individual strengths and operational priorities.
Take ownership of assigned billing and AR responsibilities with minimal supervision and limited hand-holding.
Communicate claim issues, investigation findings, resolution progress, and recurring challenges clearly and proactively.
Collaborate effectively with team members to maintain continuity and accountability across billing operations.
Adapt to changing workloads and take ownership of additional responsibilities as the organization brings more revenue cycle management functions in-house.
Quickly absorb a meaningful volume of existing billing and AR work while maintaining accuracy and productivity.

Qualifications & Requirements

Strong hands-on experience in healthcare Revenue Cycle Management (RCM) and Accounts Receivable (AR).
Proven experience managing medical billing operations, insurance claims, denial resolution, and payer follow-ups.
Direct experience in ABA billing is highly preferred.
Deep understanding of claim denials, claim status investigations, corrected claims, resubmissions, payer rules, collections, and denial root-cause analysis.
Working knowledge of insurance billing requirements, reimbursement policies, and claims submission procedures.
Familiarity with ABA-specific billing requirements, including payer restrictions involving concurrent supervision and RBT direct care services.
Demonstrated ability to independently identify denied and aging claims, investigate issues, and drive them through resolution.
Experience managing high-volume accounts receivable workloads and prioritizing claims based on urgency and financial impact.
Strong analytical and problem-solving skills, particularly in identifying recurring billing issues and implementing corrective actions.
Excellent organizational skills and attention to detail.
Strong written and verbal communication skills, with the ability to coordinate effectively with internal teams and external insurance payers.
Ability to work independently, take initiative, and manage responsibilities with minimal supervision.
Comfortable working in a fast-paced environment and adapting to evolving processes and operational requirements.

Preferred Experience & Technical Skills

Previous experience using Candid, particularly in healthcare billing, claims management, denial resolution, and accounts receivable workflows.
Familiarity with insurance payer portals and online claim-status systems.
Experience using claims management and denial tracking tools.
Proficiency in Microsoft Excel or Google Sheets for claims tracking, AR aging analysis, and reporting.
Familiarity with Slack or similar team communication platforms.
Experience working with modern healthcare billing and RCM systems.
Exposure to workflow automation, process improvement initiatives, or technology-driven billing solutions.

Ideal Candidate Profile

We are looking for a senior-level RCM professional who demonstrates strong operational ownership and does not simply wait for assigned tasks.

The ideal candidate:

Takes initiative: Regularly checks billing systems, identifies denied and aging claims, and acts on outstanding issues without waiting for instructions.
Owns the resolution process: Takes responsibility for claims from initial investigation through correction, resubmission, payer follow-up, and final resolution.
Understands ABA billing: Recognizes the nuances of ABA services and payer-specific billing restrictions that can affect claim acceptance and reimbursement.
Thinks analytically: Identifies recurring denial patterns, investigates root causes, and recommends long-term solutions rather than repeatedly addressing the same issues.
Is solutions-oriented: Proactively identifies potential billing issues before claims are submitted and helps prevent avoidable denials.
Is tech-minded: Comfortable navigating modern billing platforms and identifying opportunities to improve workflows through technology and automation.
Works collaboratively: Communicates effectively, coordinates responsibilities with team members, and contributes to a cohesive and accountable working environment.
Can operate independently: Quickly takes ownership of a substantial workload and delivers results with minimal supervision or hand-holding.

Hiring Priority

Immediate hiring need: At least one qualified specialist to join as soon as possible.
Potential additional headcount: A second specialist may be considered depending on the volume of work and the final assessment of ongoing billing and AR responsibilities.

Important: This is a senior, hands-on position focused on healthcare RCM, ABA billing, denial management, and accounts receivable ownership. Candidates whose experience is limited to basic medical billing, data entry, or medical records retrieval without substantial claims and AR management experience may not be suitable for this role.

Apply here: https://operationsarmy.com/application

Senior ABA Revenue Cycle / Accounts Receivable Specialist