Authorization Specialist (ABA, Speech, and OT)

Now Hiring: ABA, Speech, and OT Authorization Specialist
Location: Raynham, MA (remote)
Company: Sunflower Development Center

Sunflower Development Center is a multidisciplinary pediatric therapy practice providing ABA, Speech, and Occupational Therapy to children in a warm, family-centered environment. We are seeking a detail-oriented and highly organized Authorization Specialist to manage insurance authorizations for all three service areas and support the clinical and administrative teams.

Position Overview:

The Authorization Specialist is responsible for handling all insurance authorization submissions, tracking approvals and expirations, verifying eligibility, and ensuring that services are fully authorized and billable. This role is essential to maintaining continuity of care and ensuring timely reimbursement.

Key Responsibilities:

• Submit initial and ongoing authorizations for ABA, Speech, and OT services

• Monitor and track authorization start/end dates and units across payers

• Conduct daily eligibility checks or all active and incoming clients

• Communicate with insurance companies to follow up on pending or denied requests

• Collaborate with BCBAs, SLPs, and OTs to ensure required documentation is complete

• Maintain accurate logs and reports in internal systems and payer portals

• Support intake and billing teams by verifying benefits and prior auth requirements

• Assist with appeals or resubmissions when authorizations are delayed or denied

• Ensure compliance with payer guidelines, including MassHealth and commercial plans

Qualifications:

• Prior experience in medical or therapy-related authorization or billing roles

• Strong understanding of ABA, Speech, and OT authorization workflows

• Familiarity with MassHealth, commercial payers, and managed care organizations

• Excellent attention to detail and follow-through

• Strong communication and problem-solving skills

• Comfort using payer portals and EMR or practice management systems

• Ability to work independently and prioritize multiple tasks

• Knowledge of HIPAA and patient confidentiality standards

Preferred but Not Required:

• Experience with Carelon, Mass General Brigham Health Plan, and Optum

• Familiarity with ABA-specific billing codes (97151, 97153, etc.)

Schedule and Compensation:

• part-time depending on candidate availability

• In-person preferred for team collaboration

• Competitive hourly rate based on experience

• 401k, paid sick time, and opportunity for growth within the organization