Job Description 

Insurance & Financial

• Verify commercial insurance policies on file are active without changes in effective dates or future termination dates

• Verify all clients’ Forward Health (Medicaid) policies on file are active without changes in termination dates and/or changes in commercial policies shown in Forward Health’s records, as well as verify clients without Forward Health policies on file have not obtained Medicaid

• If changes with insurance occur,

  • Notify authorizations supervisor/Client Coordination Director of any changes to insurance for new and/or existing clients

  • Notify Forward Health of any coverage discrepancies

  • Contact the client’s family for the necessary information and/or documentation (e.g. policy and/or group number, effective date, insurance cards)

• Create, send out for signature, and upload a signed Financial Plan of Care for each client
  Please see the “Paperwork Procedures” Google Doc for further explanations of FPOC procedure

• Occasionally monitor Gmail account for Billing to ensure all emails have properly been forwarded and/or no important emails have been misfiled in the spam folder

• ​

Client Documents and Assessments

• Obtain paperwork required for authorizations supervisor/Client Coordination Director to submit pre-authorization requests, including but not limited to:

  • Diagnostic reports

  • Annual Paperwork containing releases of information

  • Prescriptions for ABA services

  • IEP, ISP, 504 plans, and school evaluation reports

  • Vineland assessments

  • Assessments specific to clients with Tricare insurance (please note, these assessments should be monitored for the expiration date and reported to the authorizations supervisor/Client Coordination Director, as a non-BCBA is not able to send these assessments)

  • POCs and/or discharge reports from other therapies
    Please see the “Paperwork Procedures” Google Doc for further explanations of procedures for the above paperwork

• Obtain other liability-related paperwork for clients, including but not limited to:

  • Sunscreen & Insect Repellent authorizations forms (both clinics)

  • Clinic Medication Procedures paperwork (Pleasant Prairie clinic only)

  • Parent and/or doctor authorization forms for the administration of medication  (Pleasant Prairie clinic only)

  • Child Pick Up authorizations (as able to for Pleasant Prairie clinic)
    Please see the “Paperwork Procedures” Google Doc for further explanations of procedures for the above paperwork

• Monitor Gmail account for Scan to ensure signed Adobe Sign documents have been uploaded to Central Reach

• Periodically monitor Gmail account for Fax, as needed

• Assist in the intake process for new and/or returning clients, keeping the Client Coordination Director up to date on any changes

• Respond to emails sent to the Gmail account for Contact via website submission, as needed

• Maintain client paper folders and upload documents to Central Reach with classifications, including but not limited to:

  • Documents from paper file that are no longer needed

  • Signed crisis reports and/or lead notes

  • Incident, situation, and/or safety care reports

  • Paperwork that has been printed and a paper copy signed

 

Provider Credentialing

• Acquire all necessary up to date (non-expired) documentation for the credentialing process, including but not limited to:

  • Bachelor’s and/or master’s diploma and/or official transcripts

  • Adequate background check (performed annually)

  • NPI and CAQH number

  •  Wisconsin License

  • BACB certificate/card

  • Professional Liability Insurance (COI)

  • W-9 for contracted employees

  •  CPR certification

  • RBT certificate/letter

• Credential and/or re-credential all providers with the necessary insurance companies, including but not limited to:

  • Submitting all newly hired BTT’s, BTTh’s, and BTLS’s with Forward Health

  • Performing a Demographic Update for changes in supervisor, practice location, name, and/or position for providers already credentialed with an insurance company and/or Forward Health

• Monitor Gmail account for Credentialing to ensure all correspondence are appropriately reported in activity log, documents are appropriately uploaded to Central Reach and classified, and/or emails are forwarded to the appropriate department (e.g. authorizations, billing, etc.)

• Ensure credentialing procedures for each insurance company are up to date in the Central Reach note & form

 

Central Reach Support

• Ensure Cheat Sheet documents are up to date for use by supervisory staff

• Use Adobe to create forms that are able to easily be completed via use of a PDF program

• Maintain up to date classifications of documents uploaded to Central Reach

• Maintain up to date information for contacts

• Connect staff and clients as needed

• Assist in editing of client Learning Trees as needed (per request of Client Coordination Director)

 

Bilingual Client and Staff Support

• Assist in translation of spoken and written communications including but not limited to intake calls and meetings, parent training, lead visits, etc.

• Assist in the translation and proofreading of clinical and non-clinical training materials for both parents and staff members in CR Institute.

• Assist with translation as needed with clients at the request of clinical leadership.

 

Requirements  

• High school diploma required; Bachelor’s degree or other technical studies in Business or experience as an administrative assistant is preferred

• Professional proficiency in reading, speaking, and writing in the Spanish language is required

• At least 2 years of experience in ABA in preferred

• Must have basic PC knowledge, minimum typing speed of 35 wpm, ability to write and communicate professionally

• Must have knowledge of Google Suite or Microsoft Office Suite

• Must be service oriented and possess the ability to work under pressure.

• Must have knowledge of and strict compliance with HIPAA

• Must possess the ability to complete multiple tasks simultaneously and to meet deadlines simultaneously.

 

ADA Requirements

• Ability to lift and carry up to 20 pounds regularly

• Finger dexterity to type on a computer keyboard 

• The ability to grasp objects such as pencils, pens, markers etc.    

• Manage Moderate to high stress levels in a healthy manner 

• Be able to actively engage with clients and staff