Quality Specialist, Board Certified Behavior Analyst

This is a fully remote position, open to applicants in United States.

📋 Description

• Perform systematic evaluations of ABA treatment plans and session documentation to ensure clinical accuracy, completeness, compliance, and client results.

• Analyze individualized ABA treatment plans for medical necessity, ensuring alignment with assessment results, evidence-based interventions, goal operationalization, and measurement systems.

• Evaluate treatment plans for compliance with payer, BACB ethical standards, and state regulations.

• Offer written feedback and actionable suggestions to supervising BCBAs and clinical teams.

• Monitor treatment plan submissions and their approval statuses; escalate recurring deficiencies to clinical leadership.

• Review CPT 97153 session notes for adherence to protocols, data collection, prompting levels, and client responses.

• Examine CPT 97155 session notes for BCBA participation, protocol adjustments, clinical rationale, and supervision documentation.

• Identify and relay documentation shortcomings to clinicians.

• Track documentation error patterns and collaborate on focused training and process enhancements.

• Stay informed about payer policies, BACB ethical guidelines, and state licensure requirements.

• Create and enhance quality audit tools, checklists, and standard operating procedures.

• Assist in audit preparation and address payer documentation inquiries.

• Report documentation-related claim issues to the VP of Quality & Compliance.

• Undertake additional tasks as assigned by the supervisor.

⛳️ Requirements

• Current Board Certified Behavior Analyst (BCBA) certification in good standing with the BACB.

• Active state licensure or eligibility in relevant jurisdiction(s) as required.

• At least 3 years of clinical experience in an ABA environment delivering or supervising services.

• Strong understanding of ABA CPT codes, specifically 97153 and 97155, and their associated documentation standards.

• Knowledge of Medicaid and commercial insurance payer requirements for ABA service authorization and billing.

• Excellent analytical, written communication, and organizational skills.

🏝️ Benefits

• Comprehensive health and wellness benefits.

• Opportunities for professional development and continuing education.

• Flexible work schedule options.

• Supportive work environment with a focus on quality care.