Payer Strategy Analyst

ABC Story:

Our story began in 2017 in Austin, TX. We started with humble roots but big aspirations. From 1 center in North Austin, our movement has inspired thousands of clinicians and operators. Today, the ABC community is 10,000+ strong, serving thousands of children with ASD. Growth with intentionality:
We have an intentional focus on our core values. Each center is purpose-built, and each community of teammates is nurtured.

The Payer Strategy Analyst owns the end-to-end lifecycle of case-by-case insurance contracts. In this role, you will analyze incoming out-of-network referrals, negotiate sustainable reimbursement rates directly with commercial and Medicaid payers, and secure the necessary service authorizations. You will serve as the bridge between payers and the RCM team to facilitate smooth, compliant onboarding for new and existing families.

• 3 years+ experience in RCM-based roles
• Single Case Agreement / Network Gap Exception / Contracting - required
• Billing, AR - experience strongly preferred
• Understanding of ABA - experience preferred
• Experience in a billing company and/or large-scale healthcare organization - strongly preferred
• Deep understanding of out-of-network benefits, network adequacy laws, contract terms, and the behavioral health prior authorization lifecycle
• Proficiency or some experience with Sales Force, Zoho, or other project tracking systems

• Strong attention to detail and organizational skills
• Initiate Single Case Agreement (SCA) and Network Gap Exception processes in collaboration with internal ABC Teams (e.g. Authorization, Revenue Cycle, Ops, & Finance) and external Teams (e.g. Payers/Health Insurance Companies).
• Ability to advocate effectively and negotiate directly with Payers/major insurance carriers to secure acceptable reimbursement terms.
• Correspondence and communication with Payers/major insurance carriers, including relationship building across the SCA lifecycle.
• Exceptional verbal and written communication skills; ability to remain professional and empathetic when speaking with payers and families.
• Coordinate and submit provider and group enrollment applications for new and existing markets.
• Support new state and de novo market growth through responsibilities, including but not limited to: enrollment activities, ensuring accurate and timely setup with payers.
• Track enrollment application status, follow up on payer requests, and resolve enrollment-related issues.
• Review provider and group enrollment submissions for accuracy and completeness, identifying credentialing concerns and requesting appropriate follow-up information as needed.
• Complete EFT and ERA enrollments and communicate confirmation to collaborating internal teams.

• Work closely with the Credentialing Department to align enrollment and credentialing workflows.
• Partner with contracting specialists to support group updates, demographic changes, and payer-related maintenance.
• Act as a liaison between Credentialing and Revenue Cycle Management teams to support resolution of payer enrollment and setup issues.
• Communicate with payers to respond to information requests and ensure timely enrollment completion.

• Maintain accurate provider, group, and payer records across internal systems and databases.
• Organize and maintain payer documentation, including Single Case Agreements Agreements (SCAs), enrollment records, and related materials.
• Track renewal timelines, payer requirements, and compliance-related documentation for existing markets.

• Establish, document, and follow enrollment processes and workflows appropriate…