Senior Billing Coordinator (ABA / Therapy)
MedCare Pediatric | Headquarters – Stafford, TX | Full-Time
MedCare Pediatric is seeking a highly experienced Senior Billing Coordinator to join our centralized billing team. This role is designed for an accomplished biller with 5+ years of ABA and pediatric therapy billing experience, deep knowledge of Texas Medicaid Managed Care Organizations (MCOs), and proven expertise resolving complex denials.
Key Responsibilities:
- Review and process ABA and therapy medical records to ensure accurate, compliant billing
- Submit claims after verifying authorizations, units, modifiers, place of service, and rendering provider details
- Lead resolution of MCO-specific denials including authorization mismatches, unit overages, timely filing, missing modifiers, credentialing issues, and medical necessity reviews
- Independently work denials and underpayments from Texas Medicaid MCOs including Texas Children’s Health Plan (TCHP), Superior HealthPlan, WellPoint, Molina Healthcare, UnitedHealthcare Community Plan, and Community Health Choice
- Prepare and submit reconsiderations, appeals, corrected claims, and dispute packets in accordance with payer-specific timelines and requirements
- Manage commercial ABA payer denials with carriers such as Aetna, Cigna, Blue Cross Blue Shield of Texas, UnitedHealthcare, Tricare, and Optum
- Verify insurance eligibility and ABA authorization parameters (units, frequency, date ranges)
- Partner with clinicians and operations teams to correct documentation deficiencies and prevent repeat denials
- Utilize EMR platforms such as Raintree, KanTime, WebABA, or similar therapy-focused systems
Qualifications:
- 5+ years of ABA or pediatric therapy billing experience
- Demonstrate expertise resolving Texas Medicaid MCO denials (TCHP, Superior, Amerigroup, Molina, UHC Community, CHC)
- Strong knowledge of ABA authorization structures, unit limits, and modifier requirements
- Experience billing commercial ABA carriers (Aetna, Cigna, BCBS TX, UHC, Tricare, Optum)
- EMR experience with Raintree, KanTime, WebABA strongly preferred
- Advanced attention to detail, follow-through, and compliance
Compensation & Growth:
- Pay Range: $24.00 – $32.00 per hour
- Includes a 90-day performance review with potential compensation evaluation
Apply today to bring your ABA and therapy denial-resolution expertise to a mission-driven pediatric organization.
$24 - $32 an hour
We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.