ABA Authorization Expert

 (SUD) treatment. We are committed to delivering exceptional service and innovative solutions to our clients. As a result, Plutus Health Inc. has been recognized on the Inc 5000 list of the fastest-growing private companies in America and ranked Dallas 100™ winner by the SMU Cox Caruth Institute for Entrepreneurship. Additionally, the company has been a 2024 finalist in the EY Entrepreneur Of The Year.
Job Summary:

Plutus Health Inc. is seeking a highly skilled ABA Authorization Expert to oversee and optimize the authorization and re-authorization process for Applied Behavior Analysis (ABA) services. This role requires extensive experience managing large volumes of authorizations while maintaining a strong client interface to ensure seamless communication, exceptional service delivery, and adherence to payer requirements. As a key member of our team, you will play a critical role in driving efficiency, resolving challenges, and enhancing operational outcomes.
Key Responsibilities
• Authorization Management: Oversee the complete authorization and re-authorization process for ABA therapy services, ensuring compliance with payer guidelines and regulations while managing high volumes efficiently.
• Client Interfacing: Serve as the primary point of contact for clients regarding authorization-related activities, building strong relationships and maintaining open communication.
• Denial Resolution: Proactively address and resolve authorization denials, delays, or discrepancies to minimize service interruptions.
• Documentation Oversight: Ensure clinical documentation aligns with payer standards and work closely with clinicians to acquire any additional required information.
• Process Improvement: Continuously evaluate, refine, and implement best practices in authorization workflows to enhance efficiency and reduce turnaround times.
• Stakeholder Collaboration: Act as a liaison between insurance companies, clinical teams, and clients to ensure smooth operations and issue resolution.
• Performance Monitoring: Track and report key performance indicators (KPIs), including authorization success rates and turnaround times, while providing actionable insights to leadership.
Qualifications
• Bachelor's degree in healthcare administration, business, or a related field (preferred).
• 5+ years of experience managing large volumes of ABA authorizations and re-authorizations.
• Strong knowledge of ABA therapy practices, payer guidelines, and insurance protocols.
• Proven experience in client interfacing and stakeholder management.
• Proficiency in RCM software and healthcare management systems.
• Exceptional analytical, organizational, and problem-solving skills.
• Excellent communication and interpersonal abilities.
Why Join Plutus Health Inc.?
• Work for a fast-growing, innovative company recognized for excellence in the healthcare industry.
• Collaborate with a team that values growth, diversity, and professional development.
• Make a significant impact on patient care, client satisfaction, and operational success.