Billing Clerk

Sprout Therapy PDX•Portland, OR

About The Position

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.

Requirements

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

Nice To Haves

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

Responsibilities

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
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
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
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.