Billing Clerk

Sprout Therapy PDX Billing And Claims Specialist

About Sprout Therapy PDX: Here at Sprout, we believe in creating the best atmosphere for our clients and employees and giving back to our community. Our mission is to help members of our communities reconnect with the things that are truly important and thrive, both in their own lives and in their relationships. We strive to make wellness a down to earth practice. Our vision is to eliminate mental health stigma by creating awareness of, appreciation for, and acceptance of mental health self-care. We are a fun, dynamic, and collaborative team who values working collaboratively and helping improve the health and wellness of our communities.

Our Core Values

Sprout Therapy PDX abides by the following values and seeks to hire staff who bring these ideas to life:

Clinical Excellence and Confidence: We understand the challenges faced by mental health professionals in dysfunctional systems and seek to create a space where individuals with strong clinical minds can perform their work confidently and independently within a healthier system. Join us in creating a supportive environment where you can make a meaningful difference in the lives of your clients. We admire strong clinical minds who can perform their work with confidence and independence.

Love and Enthusiasm for Mental Health: We are looking for individuals who have a deep love and enthusiasm for mental health. If you feel drawn to this field and are passionate about making a positive impact on the experience of both clinicians and clients alike, Sprout Therapy PDX is the place for you. We want team members who practice what they preach, show up with excitement, and are dedicated to the powerful work we do.

Awareness and Integration of Intersectionality: Sprout Therapy PDX is committed to serving a diverse range of clients and we do our best to integrate intersectionality into all areas of our practice. We recognize the importance of understanding and considering the unique experiences and challenges faced by marginalized individuals. Therapy is a political act; our team must have consideration for others' lived experiences and have awareness of how our own privileges and biases impact our practice. If you are aware of your own intersectionality and demonstrate consideration for others' lived experiences, we invite you to join our team.

Emotional Intelligence and Flexibility: Emotional intelligence and flexibility are crucial at Sprout Therapy PDX. We prioritize creating a warm and supportive environment for our clients, as well as our colleagues and staff. We seek individuals who demonstrate unconditional positive regard and assume the best in the face of challenges, disagreements, or conflict. As a growing new(er) business, flexibility is equally important, as procedures, policies, and workflows are sure to change during your tenure with us.

Duties/Responsibilities

Billing & Claims Management:

1. Submit insurance and Medicaid claims accurately and timely via electronic claim submission
2. Monitor claim status and manage claim workflows through the EHR and payer portals
3. Follow up on unpaid, rejected, or denied claims electronically and by phone
4. Review EOBs, EOPs, and RAs to ensure accurate payment posting and reconciliation
5. Submit corrected, secondary, or resubmitted claims as needed until payment is received
6. Make coding and modifier adjustments in collaboration with leadership as required
7. Track claims and maintain organized billing records and reporting

Client Billing & Customer Service:

1. Respond to client inquiries regarding invoices, statements, balances, and payments
2. Explain charges, insurance determinations, copays, deductibles, and balances due in a clear and supportive manner
3. Coordinate payment arrangements when applicable and escalate concerns appropriately
4. Maintain a client-centered, respectful, and professional billing experience

Insurance Verification & Support:

1. Verify insurance benefits and eligibility electronically and by phone
2. Confirm coverage details including copays, deductibles, authorization requirements, and exclusions
3. Communicate verified benefits and changes to clients, clinicians, and leadership as needed
4. Support intake and onboarding workflows related to insurance verification when required

General Practice Management:

1. Work with Intake Coordinator to provide client and clinician support regarding insurance and billing questions
2. Support staff as needed on general billing/coding questions
3. Ability to stay organized amidst multiple tasks and roles.
4. High attention to detail and ability to prioritize various projects independently.
5. Be a problem solver and think ahead to ensure any challenges don't greatly impact progress or outcomes for clients or Sprout Therapy PDX.
6. Ability to set goals and develop achievable timelines to hit them.
7. Regular and reliable attendance and timely arrival to work is required.
8. Attend mandatory staff meetings and training as directed by Sprout Therapy PDX.
9. Passion for working with others (being collaborative) and helping our team members grow and learn.
10. Other duties as assigned.

Qualifications and Skills

Alignment with our company's culture, mission, and values

At least 3+ years billing experience in mental health systems or agencies is a plus

Knowledge of Sprout Therapy PDX client experience goals and how to achieve client satisfaction

Be organized and detail oriented, punctual, and professional

Self-directed, responsible, confident, and quick

Have strong written and verbal communication skills and strong interpersonal and customer service skills

Sprout Therapy PDX is an equal opportunity employer. We are committed to providing equal employment opportunities to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability, sexual orientation, gender identity, genetic information, or any other characteristic protected by applicable law. In addition, Sprout Therapy PDX complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has employees. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.

Please note that this job description is not intended to be a contract, implied or otherwise, and may be revised or updated at any time at the discretion of Sprout Therapy PDX. Employment with Sprout Therapy PDX is at-will, meaning that both the employee and Sprout Therapy PDX have the right to terminate the employment relationship at any time, with or without cause or notice.