Who We Are At Sprout Therapy:
Sprout Therapy is a tech-forward provider of pediatric therapy across the United States. We believe that families, clinicians, and insurers all deserve a better healthcare experience, so we built one.
Backed by >$30mm from General Catalyst, Felicis Ventures, Founders Fund, & others. 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, caring professionals to help us improve autism care.
About the Role
The Patient Responsibility Account Specialist is the client point of contact for all things pertaining to the client’s patient responsibility amounts owed for services. This includes reviewing and preparing clients monthly statement of amounts owed. Assisting clients with understanding the complexities of their healthcare coverage and out of pocket responsibilities, including resolving customer inquiries to their amounts owed.
We are looking for an experienced and compassionate individual who can navigate and decipher the client’s insurance EOB’s, and policy and plan benefits. This includes a strong knowledge of insurance claims processing practices.
What You’ll Do:
- Generates monthly statements and invoices for clients
- Reviews statements and invoices for billing discrepancies
- Apply appropriate discounts and adjustments based on individual client agreements.
- Perform timely responses to client inquiries regarding their balances
- Verify client’s insurance benefits, network status and all client policy patient responsibility requirements.
- Contact client’s insurance claims ensuring claim was properly processed as expected.
- Escalates incorrect payer responses with payer’s claims processing supervisors
- Work assigned accounts
- Work all aging reports in the designated timeframe.
- Answer phone call from patient, payors and referrals pertaining to patient responsibility 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 unsatisfactory client outcomes.
- Follow company and department protocols.
What You’ll Need:
- Remote work from home, requires reliable intranet and acceptable work from home setting.
- Must be highly professional, compassionate and possess a positive attitude toward resolving billing disputes and inquires.
- Must be a self-starter, working well without close supervision
- 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
- High School graduate with 3-years’ experience in health care receivables, specifically working with clients and customers directly.
- Organizational skills and efficient time management skills
- Excellent problem-solving 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
- Must achieve goals beyond minimal levels of performance
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 patients. 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 patients. 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 in the following cities: San Francisco, New York, Los Angeles, 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:
- Patients first, everything else second: We put our patients 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.