Are you an experienced BCBA who is passionate about clinical quality, mentorship, and creating ... In this role, you'll help ensure the highest standards of ABA services by auditing documentation ...
Quick apply
Are you an experienced BCBA who is passionate about clinical quality, mentorship, and creating ... In this role, you'll help ensure the highest standards of ABA services by auditing documentation ...
... BCBA caseload assignments and workload balancing. * Track staffing metrics and operational ... Quality assurance or compliance auditing * Process improvement experience What We're Looking ForThe ...
New
Quick apply
... BCBA caseload assignments and workload balancing. * Track staffing metrics and operational ... Quality assurance or compliance auditing * Process improvement experience What We're Looking ForThe ...
New
Insurance Auditor Bcba information
What is an insurance auditor BCBA?
An Insurance Auditor BCBA is a Board Certified Behavior Analyst who specializes in auditing clinical documentation and billing practices for insurance compliance. They review treatment plans, progress notes, and submitted claims to ensure that services provided by behavior analysts meet insurance standards and regulations. Their role helps prevent fraudulent billing, improves quality assurance, and ensures that clients receive appropriate and authorized care. Insurance Auditor BCBAs often work for insurance companies or as independent consultants, and they must have a deep understanding of both applied behavior analysis and insurance policies.
How does an insurance auditor BCBA typically collaborate with clinical teams and insurance providers to ensure compliance and accurate billing?
An Insurance Auditor BCBA works closely with both clinical teams and insurance providers to review treatment plans, verify service documentation, and ensure billing practices align with regulatory and payer requirements. This role often involves conducting internal audits, providing feedback to clinicians on documentation standards, and serving as a liaison during insurance reviews or audits. Successful collaboration requires clear communication, up-to-date knowledge of industry guidelines, and attention to detail to prevent claim denials and support ethical service delivery.
What are the key skills and qualifications needed to thrive as an insurance auditor BCBA, and why are they important?
To excel as an Insurance Auditor BCBA, you need a deep understanding of applied behavior analysis (ABA), strong analytical skills, and certification as a Board Certified Behavior Analyst (BCBA). Familiarity with insurance billing systems, coding practices (such as CPT codes), and compliance documentation is essential. Attention to detail, integrity, and effective communication are crucial soft skills for reviewing claims and collaborating with providers. These competencies ensure accurate audits, minimize fraud, and support regulatory compliance within the behavioral health insurance sector.
What is the difference between Insurance Auditor Bcba vs Insurance Claims Adjuster?
| Aspect | Insurance Auditor Bcba | Insurance Claims Adjuster |
|---|---|---|
| Required Credentials | BCBA certification, relevant insurance auditing experience | Adjuster license, insurance knowledge |
| Work Environment | Healthcare, insurance companies, auditing settings | Insurance companies, claims departments, field or office |
| Industry Usage | Used mainly in health insurance and behavioral health sectors | Used across various insurance lines including health, auto, property |
Insurance Auditor Bcba and Insurance Claims Adjuster roles both involve evaluating insurance claims, but the Auditor Bcba focuses on behavioral health and insurance compliance, requiring BCBA credentials. In contrast, Claims Adjusters handle a broader range of insurance claims across multiple lines, often needing an adjuster license. While both work within the insurance industry, their specific environments and expertise areas differ significantly.
What are popular job titles related to Insurance Auditor Bcba jobs in Michigan? For Insurance Auditor Bcba jobs in Michigan, the most frequently searched job titles are:
What job categories do people searching Insurance Auditor Bcba jobs in Michigan look for? The top searched job categories for Insurance Auditor Bcba jobs in Michigan are:
What cities in Michigan are hiring for Insurance Auditor Bcba jobs? Cities in Michigan with the most Insurance Auditor Bcba job openings:
Board Certified Behavior Analyst Clinical Quality Assurance
Detroit, MI • Remote
$100/hr
Full-time
Medical, Dental, Vision, Retirement, PTO
Posted 24 days ago
Job description
Clinical Quality Assurance BCBA Lead Clinical Excellence. Improve Outcomes. Shape the Future of ABA.
Are you an experienced BCBA who is passionate about clinical quality, mentorship, and creating exceptional client outcomes?
We're looking for a Clinical Quality Assurance BCBA to join our growing clinical leadership team. In this role, you'll help ensure the highest standards of ABA services by auditing documentation, supporting clinicians, improving clinical processes, and maintaining compliance across our organization.
If you enjoy improving systems, coaching fellow BCBAs, and making a meaningful impact beyond your own caseload, we'd love to meet you.
What You'll DoConduct clinical quality audits of treatment plans, progress reports, and behavior intervention plans
Review documentation for payer, BACB, and state compliance
Partner with Clinical Directors to improve documentation quality and clinical consistency
Identify trends and opportunities for quality improvement across the organization
Develop and maintain clinical policies, SOPs, and best practices
Support insurance authorization reviews and documentation standards
Assist with internal clinical audits and accreditation readiness
Provide feedback and coaching to BCBAs on documentation and clinical quality
Track quality metrics and report findings to leadership
Collaborate with operations and clinical teams to enhance client outcomes
Required
Current BCBA certification in good standing
Master's degree in Applied Behavior Analysis, Psychology, Education, or a related field
Minimum of 3 years of BCBA experience
Strong knowledge of BACB Ethics Code and payer documentation requirements
Exceptional written communication and documentation skills
Experience using electronic health record systems (CentralReach, Rethink, Catalyst, or similar)
Highly organized with excellent attention to detail
Preferred
Previous experience in quality assurance, utilization review, or clinical leadership
Experience preparing for payer or accreditation audits
Multi-state ABA experience
Experience training or supervising clinicians
Competitive salary
Remote work opportunity
Health, dental, and vision insurance
Paid Time Off
Paid holidays
401(k) with company match (if applicable)
Continuing education reimbursement
BCBA recertification support
Career advancement opportunities
Collaborative and supportive leadership team
You'll have the opportunity to influence clinical quality across an entire organization instead of focusing on one caseload. Your expertise will help improve client outcomes, strengthen clinician development, and build systems that support long-term excellence in ABA services.
If you're passionate about raising the standard of care while working alongside an experienced leadership team, we'd love to hear from you.
Apply today to become our next Clinical Quality Assurance BCBA.