Reports to: Val Barlow, Clinical Administrator
Duties/Responsibilities:
Billing & Claims Management
- Submit insurance and Medicaid claims accurately and timely via electronic claim submission
- Monitor claim status and manage claim workflows through the EHR and payer portals
- Follow up on unpaid, rejected, or denied claims electronically and by phone
- Review EOBs, EOPs, and RAs to ensure accurate payment posting and reconciliation
- Submit corrected, secondary, or resubmitted claims as needed until payment is received
- Make coding and modifier adjustments in collaboration with leadership as required
- Track claims and maintain organized billing records and reporting
Client Billing & Customer Service
- Respond to client inquiries regarding invoices, statements, balances, and payments
- Explain charges, insurance determinations, copays, deductibles, and balances due in a clear and supportive manner
- Coordinate payment arrangements when applicable and escalate concerns appropriately
- Maintain a client-centered, respectful, and professional billing experience
Insurance Verification & Support
- Verify insurance benefits and eligibility electronically and by phone
- Confirm coverage details including copays, deductibles, authorization requirements, and exclusions
- Communicate verified benefits and changes to clients, clinicians, and leadership as needed
- Support intake and onboarding workflows related to insurance verification when required
General Practice Management:
- Work with Intake Coordinator to provide client and clinician support regarding insurance and billing questions
- Support staff as needed on general billing/coding questions
- Ability to stay organized amidst multiple tasks and roles.
- High attention to detail and ability to prioritize various projects independently.
- Be a problem solver and think ahead to ensure any challenges don’t greatly impact progress or outcomes for clients or Sprout Therapy PDX.
- Ability to set goals and develop achievable timelines to hit them.
- Regular and reliable attendance and timely arrival to work is required.
- Attend mandatory staff meetings and training as directed by Sprout Therapy PDX.
- Passion for working with others (being collaborative) and helping our team members grow and learn.
- 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.