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:
At Sprout, we are seeking an Authorization Specialist who will be responsible to handle all aspects of authorizations and submissions for our clients. The ideal candidate will demonstrate through actions, a consistent performance standard of excellence when handling critical client's information, assignments and assessments.
The expertise of the Authorization Specialist shall include working knowledge in the area of authorization related activities including pre-authorizations, notifications, edits, denials, etc. The ideal candidate has medical and pre-certification experience, strong knowledge of CPT Coding, and has worked with commercial and Medicaid insurances in the past.
What You'll Do:
What You'll Need:
- Review all authorizations and submissions for the patient's history, diagnosis, and previous treatment plans to determine procedures to avoid financial penalties to patients, providers and facilities
- Handle client's submission of pre-certification requests in a timely manner to ensure there is no delay in treatment
- Oversee and follow up with authorizations and submission from start to finish to support clinical data to payor to request approval for services being rendered
- Utilize authorization resources along with any other applicable reference material to obtain accurate information when tracking the status of on-going and initial authorizations
- Resolve appeals and assist with any escalations during the authorization process to ensure timely claim filing and elimination of payer rejections and or denials
- Responsible for the submission of initial and re-submission of all authorizations when they are due for renewal
- Reach out to all provider services while providing stakeholders with concise and updated information as needed
- Bachelor's Degree
- Previous medical and Pre-Certification experience
- CPT Coding knowledge
- Billing process experience
- Medical operations experience
- Experience working with Central Reach, NPA, Salesforce, and Microsoft Suite
- Commercial and Medicaid insurance experience
- 1+ year of insurance verification experience
- Familiarity with medical terminology
- Professional telephone courtesy and strong communication skills
- Experience in the ABA Therapy Sector is a plus
- Comfortable working in a fast paced environment
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
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.
- 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
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.