Who We Are at Sprout Therapy:
Sprout Therapy is a tech-forward provider of pediatric autism therapy across the United States.
We believe that families, clinicians, and insurers all deserve a better healthcare experience, so we built one.
Backed by over $96mm from leading investors in healthcare technology, including General Catalyst, Founders Fund, SignalFire, e.ventures, 8VC, Felicis Ventures, Sound Ventures, and Bling Capital, our mission is to provide personalized, technology-empowered care for children with autism in the environment best suited to help them grow and thrive — the home.
We're looking to rapidly grow our team with values-driven, diverse, and caring professionals to help us improve autism care.
About the Role:
Performs routine follow up on open accounts receivables that result in claim payment.
Resolve unpaid claims, understanding root causes for non-payment.
What You will Do:
We are looking for an individual that will take ownership of performing all necessary tasks and actions to achieve claim payment, make appropriate account corrections ensuring future claims are paid.
Understanding denial root causes and communicating those trends to leadership to help reduce future occurrences.
Utilizes payer portals to check claims status
Verify client's insurance benefits
Learn payer's policy and procedures, documenting payers ABA coverage policy guidelines
Effectively place calls to payor for claim payment to resolve claim payment issues/denials
Escalates incorrect payer responses with payer's claims processing supervisors
Successfully resolve claim non-payment issues resulting in claim payment
Perform routine portal, phone and written denial appeals with payers.
Work assigned accounts
Work all aging reports in the designated time frame.
Answer phone call from patient, payors and referrals pertaining to patient accounts
Adhere to Sprout policy and procedures for completing reports, forms, and office paperwork.
Reports to supervisor and/or manager any problems or issues that result in non-payment of claims.
Input and update client and payer data within Sprout's practice management systems, including NPA, Salesforce or other system infrastructures.
Follow company and department protocols.
Communicate to the supervisor / manager any potential issues or delays in updating client's information within the practice management system.
What You will Need:
Remote work from home, requires reliable intranet and acceptable work from home setting.
Must be a self-starter, working well without in person supervision
High School graduate with 3-years' experience in a healthcare related field, preferably related to billing or prior authorization policies
Must be able to perform their own research and have experience using varying methods to obtain payer related data including payer portals, effective google searches, blogs, and message boards.
Must be able to interpret payer contract language
Fully comprehend and decipher varying EOB (Explanation of Benefits)
Fully comprehend insurance claim processing behavior
Mathematics, balancing and reconciling skills
Time intelligence skills, converting payer units to 15 mins increments
Organizational skills and efficient time management skills
Willing to modify plans and behavior when necessary to meet goals
Must be able to establish priorities and a course of action for handling multiple tasks
Must be able to maintain the normal standard of ethics, conduct and organization policies in job related activities
Ability to satisfactorily perform other duties upon request by supervisor or dept head
In addition to our clinicians and supporting departments, our company is built around four cross functional teams (spanning operations, product, marketing, business development, etc.):
Demand - Deliver top notch products and services to our growing number of families.
You'll work with families to understand pain points and optimize the patient journey from first contact to start of care to offboarding.
Supply - Own and manage the relationship with our clinical practitioners.
You are responsible for the growth of our clinician ecosystem by attracting, recruiting, and retaining high quality autism care providers.
Platform - Build tools and provide services to optimize and improve the delivery of clinical care.
You'll help match the right provider with the right family, coordinate clinical care, and develop digital therapeutics products.
Quality - Improve the quality of care delivered to our families.
You'll ensure that we provide strong clinical outcomes, develop training platforms to level up our providers, and maintain compliance with a variety of payor and regulatory requirements.
At Sprout, we are a globally distributed team with many of our team members located throughout the world, including in the following cities: San Francisco, New York, Los Angeles, Miami, Toronto, Montreal, and Kyiv.
While everyone currently works remotely, we envision a future that balances face to face collaboration with a remote friendly environment.
What We Believe:
Families first, everything else second: We put our families first, always.
No decision is made at Sprout without considering the value it would bring to our families.
Think and act like an owner: We think of ourselves as not just employees but part owners.
We understand that when Sprout thrives, we all thrive.
Candor and respect: We can't achieve greatness without ever disagreeing.
We need to have healthy debates to ensure that we're making the right decisions.
Never settle for less: We don't settle for anything less than excellence.
We're relentlessly committed to delivering the best care to our patients and always strive to do better by them.
The above job description is meant to describe the general nature and level of work being performed; it is not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required for the position.
Sprout Therapy is an equal opportunity employer that is committed to providing all employees with a work environment free of discrimination and harassment.
We celebrate diversity and welcome applicants from every background and life experience.
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