Who We Are at Sprout Therapy:

Sprout Therapy is a tech-forward provider of in home and online Applied Behavior Analysis (ABA) Therapy. Our mission is to provide personalized, technology empowered care for your child’s needs in the environment best suited to help them grow and thrive — your home.

About the Role:

We are looking for an experienced Credentialing and Medical Billing Specialist that has worked in a Medical environment. You would be responsible for assembling and reviewing data, creating and submitting claims and making sure billing is handled correctly from start to finish. In this role, you will review billing-related documents for accuracy and use billing software to prepare and transmit claims. Our Billing Specialist will verify eligibility and benefits as well as obtain referrals and authorizations from insurance companies for procedures and follow-up visits.

What You’ll Do:

  • Contact providers and assists them through the credentialing process with both commercial and Medicaid Networks, following up on missing documents to ensure completion of credentialing process.
  • Monitor Staff credentials and Licensure. 
  • Prepare and submit credentialing applications and supporting documentation for the purpose of enrolling providers with commercial and Medicaid Networks. 
  • Follow up on the status of applications for providers and payers, tracking progress on all pending and completed work.
  • Reach out to potential clients and initiate the intake process, Verify eligibility and benefits
  • Collect clinical documentation for insurance authorization requests, submit and oversee authorization requests.  
  • Review billing to ensure meeting payer requirements, and assist in the quality assurance review process.

What You’ll Need:

  • Minimum two years of credentialing experience preferred 
  • Experience in Behavioral Health (Preferred) 
  • Experience in Behavioral Health Billing process (Preferred)
  • Certified Provider Credentialing Specialist (CPCS) Preferred
  • Ability to work independently, set priorities and meet deadlines with a strong sense of urgency
  • Ability to communicate effectively with all departments, clients and insurance contacts
  • Possess knowledge of basic computer programs, such as Microsoft Word and Excel, as well as database programs
  • Strong Attention to detail
  • Excellent Customer Services skills

What We Offer:

  • Flexible hours, remote work
  • Opportunities for advancement 
  • Being part of a team of hard-working, ambitious and caring individuals who will help you learn and grow professionally


Apply for this Job

* Required