Senior Manager, ABA Billing Operations
Own ABA billing end to end: authorization through cash. This is the deepest ABA revenue cycle seat we have, and it needs someone who has actually run it.
The role
What this job actually is
Mastery of the RCM metric set is mandatory: net collection rate, gross collection rate, days in AR, AR over 90 days, denial rate, first-pass resolution rate, clean claim rate, cost to collect, charge lag and DNFB. You must be able to read them, explain what moves them, and act on them.
ABA is the specialty we are known for, and this seat owns it operationally. You run the full ABA revenue cycle for our autism services clients: eligibility and benefit caps, authorization and unit management, the three-way match between authorization, session note and claim, clean claim production across 97151 to 97158, denial prevention, and AR through to cash. You lead the ABA pod and you are accountable for the metrics our clients see. ABA money does not leak at the claim, it leaks in the gaps between the authorization, the note and the rendering provider, and this role exists to close those gaps. Use BCBA and RBT correctly, because in ABA the rendering level drives the billing rule.
Ownership
What you will own
The full ABA revenue cycle
Eligibility and benefit verification, authorization management, charge and claim production, denial management, AR follow-up and cash posting for the ABA book. One connected process, not disconnected queues.
Authorization and unit integrity
Own unit burn-down against approved authorizations, reauthorization triggers well before expiry, single-case agreements, and concurrent review deadlines. Delivered care with no live authorization is preventable revenue loss.
The three-way match
Authorization equals session note equals claim, on code, units, date span and rendering provider. This control is the single biggest lever in ABA billing and you own it.
Code and rendering discipline
97151 assessment, 97153 RBT-delivered direct treatment, 97155 protocol modification with the BCBA, 97156 caregiver guidance, 97158 group, plus Category III codes where a payer still requires them. Rendering level, supervision ratio and place of service must match what the payer expects.
Benefit caps and accumulators
Track annual and lifetime caps on commercial plans and state Medicaid unit limits so late-year sessions do not quietly deny.
Multi-state payer rules
Medicaid rules change at the state line: unit caps, EPSDT protections, concurrent billing limits, modifier sets and county-based enrollment. Keep a live state-by-state rule matrix rather than one SOP.
Denial prevention over rework
Track ABA denials to root cause, authorization exhausted, rendering mismatch, concurrent overlap, missing supervision documentation, timely filing, and eliminate them upstream.
The pod
Lead ABA billers, AR specialists and the authorization desk supporting this book. Set the cadence, coach the detail, build the bench.
Ramp
Your first 90 days
First 30 days
Baseline the ABA book by the numbers: net collection rate, days in AR, AR over 90, denial rate and clean claim rate by client and payer. Pull the top denial reasons and the current authorization utilization. Find out where the three-way match is actually breaking.
By day 60
A documented state-by-state and payer-by-payer rule matrix, authorization burn-down running with reauth triggers, and the top three ABA denial root causes assigned with owners.
By day 90
Measurable movement on denial rate and AR over 90, zero preventable authorization lapses, and a pod cadence that runs without you in every meeting.
Requirements
What we look for
- MANDATORY: working command of RCM metrics, net collection rate, days in AR, AR over 90, denial rate, first-pass resolution rate, clean claim rate and cost to collect
- Six or more years in US healthcare revenue cycle with at least three years specifically in ABA or autism services billing
- End-to-end ABA command: CPT 97151 to 97158 and Category III codes, authorization and unit management, supervision and rendering rules for BCBAs and RBTs
- Multi-state Medicaid ABA experience, including how unit caps, EPSDT and concurrent billing rules differ by state
- Commercial ABA payer experience with autism mandates, benefit caps and concurrent review
- Two or more years leading a billing team with accountability for client-facing metrics
- Fluent in ABA denial patterns and able to drive root cause elimination rather than rework
Bonus
Strong plus, not required
- Experience with ABA practice management or EHR platforms and their claim exports
- Single-case agreement and out-of-network ABA negotiation exposure
- Familiarity with BCBA credentialing and county-based Medicaid enrollment
- Experience preparing ABA documentation for payer audits
- Exposure to the CPT 2027 adaptive behavior code revisions
Accountability
How this role is measured
| Measure | What it means |
|---|---|
| Net collection rate, ABA book | Owned by client, trended monthly. |
| Authorization utilization | Delivered units against authorized units, with zero preventable lapses. |
| ABA denial rate | Trending down, tracked by root cause. |
| Clean claim rate | First-pass acceptance on ABA claims. |
| Days in AR and AR over 90 | Cash velocity on the ABA book. |
| Unbilled and under-authorized revenue | Identified and recovered. |
| Three-way match compliance | Claims verified against authorization and note before submission. |
| Team quality and retention | Pod accuracy scores and attrition. |
Why ASP-RCM
Why this seat is different
We are senior-led by design. A senior partner is named on accounts and shows up in the work, which is why clients renew and why this role carries real authority rather than a title. Our AI suite is in production, not in a roadmap deck, and our compliance posture is independently audited: SOC 2 Type II with HITRUST, ISO 27001 and HIPAA.
We pay for certifications and run upskilling cohorts, because coding and revenue cycle are crafts that need investment. You will work across Dallas HQ, six US states and Chennai, India, with colleagues who have run these functions at scale.