# ABA Insurance Verifications & QA Specialist | USA Hours | Remote

**Company:** [ISTA Personnel Solutions](https://jobs.workable.com/companies/iSt64sfgHWn4ef4KKpqeK9.md)
**Location:** Remote
**Workplace:** remote
**Employment type:** Full-time
**Department:** South Africa

[Apply for this job](https://jobs.workable.com/view/4703bc33-cdd6-475b-b4f1-3f68b232bc27)

## Description

**ISTA Personnel Solutions** is a dynamic and fast-growing BPO company. We are not a recruitment agency. We partner with international US clients and integrate our staff members directly within our clients' operations. We focus on long-term placements where you contribute directly to the client's success.

We are partnering with a U.S.-based, out-of-network paediatric therapy centre offering **ABA, occupational therapy, speech and language** and related services, to recruit an **ABA Insurance Verifications & QA Specialist**.

This is a fully remote, back-office role for a confident, proactive and detail-focused individual who enjoys thinking on their feet and keeping things accurate. You will support a small in-office team by verifying out-of-network insurance benefits, managing authorisations and reviewing session notes. The role is not staff-facing at first, but the client would like to grow it into staff-facing work once you have settled in.

**PLEASE NOTE:**

-   **Working hours:** Monday to Friday, 16:00–01:00 SAST (subject to US daylight saving changes)
-   **Public Holidays:** You will be required to work on both **South African and U.S. public holidays** (compensation for SA public holidays in accordance with the BCEA).
-   **Internet Requirements:** A fixed fibre line with a minimum speed of **25 Mbps (upload & download)** and the ability to support a **wired Ethernet connection** is mandatory. Applicants without a fixed fibre line cannot be considered.
-   **Power Backup:** A **reliable power backup solution** is required to manage load shedding and power outages. Applicants without a power backup cannot be considered.
-   **Work Environment:** This is a **fully remote** working role and you must be based in South Africa.

**Job Responsibilities (but not limited to):**

-   Pick up benefit checks from the Monday.com board for new enquiries and existing clients who change insurance
-   Call US insurers to verify out-of-network benefits across all services, including coverage or exclusions, visit limits, deductibles, co-insurance and maximum out-of-pocket
-   Record benefits accurately on the board
-   Send patient responsibility contracts to parents once the payment plan has been agreed, and follow up until they are signed and returned
-   Load real or placeholder authorisations into CentralReach so therapists can bill
-   Extend or renew all authorisations before January, then re-verify every client’s benefits in the first two weeks of January when most plans reset
-   Review flagged session notes in CentralReach and NoteGuard AI
-   Check that amendment notes have been signed, then clear the label so sessions can move to payroll
-   Resolve rule flags internally where possible (for example, data entered on the wrong day) and escalate to therapists where needed
-   Over time, support authorisation utilisation checks, timesheet authorisation issues and follow-up on unconverted timesheets

## Requirements

-   ABA industry experience, with a solid understanding of the terminology (timesheets, goals, session notes, QA and authorisations). This does not need to be in billing or QA - ABA recruiting, onboarding or admin experience is sufficient
-   Comfortable speaking with US insurers via telecom
-   Proficiency in Microsoft 365, including Outlook and Excel
-   Excellent written and spoken English
-   Strong attention to detail and accuracy
-   The initiative to question anything that looks off, rather than simply following the workflow
-   The habit of communicating fully and proactively, giving real updates rather than one-word answers
-   A confident, personable manner and an easy way of working with others

### Beneficial Experience

-   CentralReach experience
-   Monday.com experience
-   US health insurance or benefits verification experience, ideally across ABA, OT and speech
-   Experience working with US or international clients
-   Creative thinker, takes initiative, discusses ideas, asks questions and communicates effectively
-   Friendly, pleasant and forthcoming personality

_If you are not contacted within 14 working days, please consider your application unsuccessful._