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Manager Bcba Insurance Reviewer Jobs in Florida (NOW HIRING)

Side by Side Behavioral Health LLC

BCBA

Winter Park, FL · On-site

$75K/yr

... managing insurance authorization submissions, following up with payers, and handling related ... Review and analyze client data. * Modify treatment protocols based on direct observation and ...

Acorn Health

Hybrid BCBA

Lakeland, FL · Hybrid

$75K - $93K/yr

Monitor and review client programs to analyze data, measure progress and make necessary changes to ... Retirement Plan * Life insurance, long term and short term disability * CEU opportunities

Pair ABA

Board Certified Behavior Analyst (BCBA)

FL · On-site +1

$48 - $55/hr

Provide overall case management across a multi-setting caseload * Work within a collaborative, BCBA ... Clinical consultation and case review access through experienced Clinical Directors and Quality ...

CivicMinds, Inc.

BCBA

Tampa, FL · On-site

$69K - $85K/yr

Complete reassessments, treatment reports, and clinical documentation in accordance with insurance ... Experience supervising RBTs preferred * Ability to manage documentation and clinical ...

Pair ABA

Board Certified Behavior Analyst (BCBA)

FL · On-site +1

$48 - $55/hr

Provide overall case management across a multi-setting caseload * Work within a collaborative, BCBA ... Clinical consultation and case review access through experienced Clinical Directors and Quality ...

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Manager Bcba Insurance Reviewer information

What does a Manager BCBA Insurance Reviewer do?

A Manager BCBA Insurance Reviewer oversees the review and approval process for insurance claims related to Applied Behavior Analysis (ABA) therapy services. They ensure that treatment plans created by Board Certified Behavior Analysts (BCBAs) meet insurance requirements and support medical necessity. Additionally, they coordinate with clinicians, insurance companies, and clients to facilitate smooth authorization and reimbursement processes. This role often involves supervising a team, providing guidance on clinical documentation, and staying updated on changing insurance policies.

What are the primary challenges faced by a Manager BCBA Insurance Reviewer when coordinating between clinical teams and insurance providers?

One of the main challenges for a Manager BCBA Insurance Reviewer is balancing the clinical needs of clients with the documentation and compliance requirements set by insurance companies. This role frequently involves ensuring that treatment plans and progress notes align with insurer guidelines while still supporting effective, individualized care. Additionally, the position requires strong communication skills to clarify clinical recommendations to insurance representatives and advocate for necessary services. Navigating policy updates, managing denials or appeals, and training clinical staff on best documentation practices are also key aspects of this role.

What are the key skills and qualifications needed to thrive as a Manager BCBA Insurance Reviewer, and why are they important?

To thrive as a Manager BCBA Insurance Reviewer, you need a Board Certified Behavior Analyst (BCBA) certification, experience in applied behavior analysis, and a thorough understanding of insurance authorization and claims processes. Familiarity with electronic health records (EHR) systems, insurance billing platforms, and compliance documentation is typically required. Exceptional organizational skills, attention to detail, and the ability to communicate effectively with both clinical teams and insurance representatives are crucial soft skills. These skills ensure accurate claims processing, compliance with insurance requirements, and optimal support for clients receiving behavioral health services.

What is the difference between Manager Bcba Insurance Reviewer vs Bcba Insurance Reviewer?

AspectManager Bcba Insurance ReviewerBcba Insurance Reviewer
CertificationsBCBA certification, management experienceBCBA certification
Work EnvironmentSupervisory role, team managementReviewing insurance claims, case assessments
Employer & IndustryHealthcare, insurance companies, behavioral healthInsurance companies, healthcare providers
Search & ComparisonOften compared for career progressionFocuses on case review and approval

The main difference is that the Manager Bcba Insurance Reviewer oversees a team and manages review processes, while the Bcba Insurance Reviewer primarily focuses on evaluating insurance claims and cases. The managerial role involves leadership responsibilities, whereas the non-managerial role emphasizes case assessment within the insurance industry.

What are the most commonly searched types of Bcba Insurance Reviewer jobs in Florida?

The most popular types of Bcba Insurance Reviewer jobs in Florida are:

What cities in Florida are hiring for Manager Bcba Insurance Reviewer jobs?

Cities in Florida with the most Manager Bcba Insurance Reviewer job openings:

Manager Bcba Insurance Reviewer jobs near you
Infographic showing various Manager Bcba Insurance Reviewer job openings in Florida as of August 2026, with employment types broken down into 50% Full Time, and 50% Contract. Highlights an 50% In-person, and 50% Hybrid job distribution.

Insurance Reviewer Clinical

The US Oncology Network

Ocala, FL • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 19 days ago

US Oncology rating

7.1

Company rating: 7.1 out of 10

Based on 109 frontline employees who took The Breakroom Quiz

379th of 898 rated healthcare providers

Job description

Overview
Why work for us?
We offer our employees a competitive benefits package that includes Medical, Dental, Vision, Life Insurance, Short-term and Long-term disability coverage, a generous PTO program, a 401k plan that comes with a company match, a Wellness program that rewards you practicing a healthy lifestyle, and lots of other great perks such as Tuition Reimbursement, an Employee Assistance program and discounts on some of your favorite retailers.
SCOPE: Under general supervision, reviews chemotherapy regimens in accordance to reimbursement guidelines. Obtains necessary pre-certifications and exceptions to ensure no delay in reimbursement of treatments. Researches denied services and alternative resources to pay for treatment. Supports and adheres to the US Oncology Compliance Program, to include the Code of Ethics and Business Standards.
Responsibilities
ESSENTIAL DUTIES AND RESPONSIBILITIES:
  • Reviews, processes and audits the medical necessity for each patient chemotherapy treatment and documentation of regimen relative to pathway adherence.
  • Communicates with nursing and medical staff to inform them of any restrictions or special requirements in accordance with particular insurance plans. Provides prompt feedback to physicians and management regarding pathway documentation issues, and payer issues with non-covered chemotherapy drugs.
  • Updates coding/payer guidelines for clinical staff. Tracks pathways and performs various other business office functions on an as needed basis
  • Obtains insurance authorization and pre-certification specifically for chemotherapy services. Works as a patient advocate and functions as a liaison between the patient and payer to answer reimbursement questions and avoid insurance delays.
  • Researches additional or alternative resources for non-covered chemotherapy services to prevent payment denials. Provides a contact list for patients community resources including special programs, drugs and pharmaceutical supplies and financial resources.
  • Maintains a good working knowledge of chemotherapy authorization requirements for all payers, State and federal regulatory guidelines for coverage and authorization. Adheres to confidentiality, state, federal, and HIPPA laws and guidelines with regards to patient's records.
  • Other duties as requested or assigned.

Qualifications
MINIMUM QUALIFICATIONS: High school degree or equivalent. Associates degree in Healthcare, LPN state license and registration preferred. Minimum three (3) years medical insurance verification and authorization required.
COMPETENCIES: -Uses Technical and Functional Experience: Possesses up to date knowledge of the profession and industry; is regarded as an expert in the technical/functional area; accesses and uses other expert resources when appropriate. -Demonstrates Adaptability: Handles day to day work challenges confidently; is willing and able to adjust to multiple demands, shifting priorities, ambiguity and rapid change; shows resilience inn the face of constraints, frustrations, or adversity; demonstrates flexibility. -Uses Sound Judgment: Makes timely, cost effective and sound decisions; makes decisions under conditions of uncertainty. -Shows Work Commitment: Sets high standards of performance; pursues aggressive goals and works efficiently to achieve them. -Commits to Quality: Emphasizes the need to deliver quality products and/or services; defines standards for quality and evaluated products, processes, and service against those standards; manages quality; improves efficiencies.
PHYSICAL DEMANDS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is required to be present at the employee site during regularly scheduled business hours and regularly required to sit or stand and talk or hear. Requires full range of body motion including handling and lifting patients, manual and finger dexterity, and eye-hand coordination. Requires standing and walking for extensive periods of time. Occasionally lifts and carries items weighing up to 40 lbs. Requires corrected vision and hearing to normal range.
WORK ENVIRONMENT: The work environment may include exposure to communicable diseases, toxic substances, ionizing radiation, medical preparations and other conditions common to an oncology/hematology clinic environment. Work will involve in-person interaction with co-workers and management and/or clients. Work may require minimal travel by automobile to office sites.

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