Senior Associate - ABA practice

The Senior Prior Authorization Associate is responsible for managing the end-to-end prior authorization process for ABA (Applied Behavior Analysis) services, ensuring authorizations are obtained accurately and on time to prevent any disruption to client care. This role requires strong payer knowledge, sharp attention to detail, and the ability to independently manage a high volume of complex cases, including denials, appeals, and peer-to-peer coordination.

The Senior Prior Authorization Associate will also ensure timely authorization approvals, conduct 100% quality audits, and provide & handle escalated Authorization Cases.

Key ResponsibilitiesIntake Operations
Manage and monitor incoming tickets, referrals, and fax queues
Ensure all intake requests are triaged, responded to, and completed on time
Maintain SLA adherence and optimize turnaround times
Ensure accurate patient intake, insurance verification, and data entry
Prioritize urgent cases to prevent delays in care

Prior Authorization Oversight
Oversee end-to-end prior authorization processes
Ensure authorizations are obtained timely and prior to patient visits
Track pending requests and follow up with payers
Handle escalated delays and complex cases as needed

Quality Assurance
Conduct 100% audit of auth output (intake and auth)
Ensure compliance with payer guidelines and internal standards
Identify errors, trends, and implement corrective actions
Serve as escalation point for issues and bottlenecks

Training & Development
Train, onboard, and coach auth co-workers
Develop SOPs and workflow documentation
Provide continuous feedback to improve quality and efficiency

Collaboration
Work closely with scheduling, billing, and clinical teams
Communicate intake and authorization updates proactively
Partner with leadership to improve RCM performance

Qualifications Required
3+ years of experience in Revenue Cycle Management (RCM)
Experience working in an Outpatient ABA Therapy Clinic
Experience working in TX behavioral health market
Experience working in authorization-related denials
Strong knowledge of intake, insurance verification, and prior authorizations
Experience managing work queues (tickets, faxes, referrals)
Prior supervisory experience

Preferred
Experience with EMR/EHR systems
Familiarity with U.S. insurance payers and authorization rules
Process improvement experience is a plus

Skills
Strong attention to detail and accuracy
Excellent communication and leadership skills
Ability to manage multiple priorities in a fast-paced environment
Problem-solving and analytical mindset

Key Metrics for Success
Intake turnaround time (TAT)
Authorization turnaround and approval rates
Queue resolution times
Audit accuracy (target: 100%)
Reduction in authorization-related denials

Experience:

RCM: 3 years (Required)

Work Location: Remote