Remote BCBA – ABA Quality Assurance & Payor Compliance Lead (North Carolina)

Abode ABA is seeking an experienced BCBA to lead the design and oversight of our ABA QA and payor compliance program. This is a senior, clinical authority role focused on protecting documentation integrity, ensuring compliance with North Carolina payor requirements, and reducing audit and recoupment risk. This position is not a high-volume note review role. We already have team members conducting reviews. This role exists to build the QA framework, oversee standards, identify risk trends, and provide clinical authority and direction to the QA process. The ideal candidate is intimately familiar with North Carolina payors, has been directly involved in payer audits or investigations, and has participated in audit response and remediation efforts. Key Responsibilities • Design, implement, and oversee a QA session documentation program aligned with NC payor requirements • Establish QA standards, rubrics, workflows, and escalation pathways • Provide final clinical authority on documentation compliance and QA determinations • Identify documentation trends, risks, and recurring issues across providers • Guide and oversee QA reviewers to ensure consistency and accuracy • Advise leadership on payor-specific risks, audit prevention, and compliance strategy • Support as-needed payer-related escalations, audits, or compliance concerns • Ensure QA processes align with CentralReach workflows and reporting Required Qualifications • BCBA certification in good standing • Deep, hands-on knowledge of North Carolina payor requirements, including Medicaid and commercial plans • Direct experience being audited or investigated by insurance payors, including participation in response and remediation • Proven experience setting up and overseeing QA programs for ABA documentation • Strong working knowledge of CentralReach • Excellent clinical judgment and ability to make firm, defensible compliance decisions • Comfortable operating independently with high-level responsibility Why This Role • Senior-level clinical authority without day-to-day caseload demands • Fully remote with flexible, as-needed hours • Meaningful impact on compliance, sustainability, and clinical integrity • Collaborative, provider-led organization that values thoughtful, ethical practice Job Type: Contract Pay: From $40.00 per hour Expected hours: 1 – 5 per week Benefits: • Flexible schedule Application Question(s): • Have you been directly involved in an insurance audit or investigation related to ABA services in North Carolina, including participating in the response or remediation process? • Please briefly describe the North Carolina payors you have worked with and your direct experience with audits, recoupments, or investigations (do not include PHI). • Have you built, implemented, or overseen a QA program for ABA session documentation and payor compliance? • Do you have hands-on experience using CentralReach for QA review, documentation standards, or compliance oversight? • What do you believe is the most common documentation risk that leads to ABA recoupments in North Carolina? Work Location: Remote Apply tot his job Apply To this Job