Medical Biller & Authorizations Representative — Integrated Autism Centers
About Us: Integrated Autism Centers provides high-quality autism diagnostic and therapy services (ABA, speech, and occupational therapy) to children and families across Metro Detroit. We're looking for a sharp, dependable Medical Biller to own our revenue cycle from authorization to payment.
The Role: This is a high-trust, full-time position for someone who knows their way around insurance billing and takes pride in clean claims and a healthy A/R. You'll be the point person for our billing operations — submitting claims, chasing denials, tracking authorizations, and making sure every service we deliver gets paid. The ideal candidate is detail-obsessed, persistent with payers, and comfortable owning the full billing cycle with minimal hand-holding.
Key Responsibilities:
- Claims Submission: Prepare and submit clean claims for ABA, speech, and OT services to commercial payers and Medicaid; verify CPT codes, modifiers, units, and documentation before submission.
- Denials & Appeals: Work denials and rejections promptly; prepare appeals and resubmissions, communicate with payers, and resolve issues to keep revenue flowing.
- Insurance Authorizations: Submit, track, and follow up on authorizations and reauthorizations; monitor expiration dates and unit utilization to keep services uninterrupted.
- Payment Posting & Reconciliation: Post ERAs/EOBs, reconcile payments against expected reimbursement, and flag underpayments or contract discrepancies.
- A/R Management: Monitor aging reports, follow up on outstanding claims, and keep days-in-A/R low; provide regular reporting to leadership on collections and claim status.
- Eligibility & Benefits Verification: Verify patient coverage and benefits at intake and re-verify as needed; communicate patient responsibility clearly to families.
- Payer Documentation Requests: Gather and submit clinical documentation in response to payer records requests and pre-payment reviews, working with clinical staff to meet deadlines.
What We're Looking For:
- 1+ years of medical billing experience; ABA, behavioral health, or pediatric therapy billing strongly preferred.
- Working knowledge of CPT/ICD-10 coding, modifiers, and payer-specific billing rules; familiarity with BCBSM, Blue Care Network, HAP, UHC/Optum, Priority Health, and Michigan Medicaid is a strong plus.
- Experience with practice management/EMR systems and clearinghouses (CentralReach experience a plus).
- Strong follow-through and persistence — comfortable getting payers on the phone and staying on a claim until it's resolved.
- Excellent attention to detail and organizational skills; able to manage multiple payers, deadlines, and priorities at once.
- Clear written and verbal communication with families, staff, and insurance companies.
- Discretion and reliability when handling PHI and confidential financial information; understanding of HIPAA requirements.