AUTISM SERVICES KAUAʻI (ASK)
Lihuʻe, Kauaʻi, Hawaiʻi
ABA Billing Consultant — Contract Position
Position Overview
Autism Services Kauaʻi (ASK) is a growing ABA intervention clinic seeking an experienced ABA billing consultant for a contract engagement. This is a multi-phase project with the potential for an ongoing training and advisory relationship. The ideal candidate brings deep expertise in ABA-specific billing, Coordination of Benefits (COB) with mixed network status, and Hawaii insurance payers.
This is a remote-friendly position. Candidates do not need to be located on Kauaʻi.
Scope of Work
The engagement has three phases:
Phase 1 — Claims Audit & Remediation
- Review and audit existing claims for billing errors, missed submissions, and underpayments
- Correct and resubmit claims in accordance with each payer’s requirements
- Provide a written summary of findings and recovered/recoverable amounts
Phase 2 — COB Billing Cleanup & Rebilling
- Rebill claims correctly through the out-of-network primary insurance pathway
- Apply primary EOB to secondary in-network claims accurately
- Ensure correct crossover logic is applied where primary pays more than secondary’s allowed amount
- Resolve pending or denied COB claims with supporting documentation
Phase 3 — Systems Development & Biller Training
- Assess current billing workflows and identify gaps
- Develop and document a replicable billing system for ongoing ABA claims
- Create standard operating procedures (SOPs) for:
◦ Prior authorization tracking
◦ Claim submission timelines by payer
◦ COB sequencing and EOB application
◦ Denial management and appeal workflow
◦ Aging report review cadence
- Train ASK’s current biller on all systems, workflows, and payer-specific nuances
- Provide follow-up support during a transition period (duration to be negotiated)
Required Qualifications
- Demonstrated experience billing ABA CPT codes: 97151, 97153, 97155, 97156, 97157, 97158
- Expert-level knowledge of Coordination of Benefits (COB) billing with mixed network status (out-of-network primary / in-network secondary)
- Experience applying primary EOB correctly to secondary insurance claims
- Familiarity with Hawaii insurance payers, including one or more of: HMSA, UHA, HMAA, AlohaCare, QUEST Integration
- Ability to identify and remediate misbilled or underpaid claims
- Experience training non-specialist billers or creating billing SOPs
Preferred Qualifications
- Experience with Kareo or similar practice management platforms
- Background working with small ABA clinics or behavioral health practices
- Prior engagement in Hawaii Medicaid (QUEST Integration) ABA billing
- Ability to communicate billing concepts clearly to non-billing staff
Compensation & Terms
- Contract/1099 engagement
- Rate negotiable based on experience and scope
- Estimated duration: 60–120 days for Phases 1–3; ongoing advisory retainer possible
- Remote work; occasional video calls with clinic staff required
How to Apply
Please submit the following to [email protected]:
- Resume or CV highlighting ABA and COB billing experience
- Hourly or project-based rate
Candidates who can speak specifically to out-of-network primary / in-network secondary COB experience and Hawaii payer knowledge will be prioritized.
Pay: $25.00 - $55.00 per hour
Benefits:
Work Location: Remote
