Accounts Receivable Specialist at Elemy
Accounts Receivable Specialist
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 >$96m 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 are looking to rapidly grow our team with values-driven, diverse, 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 patients. You will 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 will 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 will 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 cannot achieve greatness without ever disagreeing. We need to have healthy debates to ensure that we are making the right decisions.
- Never settle for less: We do not settle for anything less than excellence. We are relentlessly committed to delivering the best care to our patients and always strive to do better by them.