Credentialing Specialist, New Ventures - Remote

Who We Are at Sprout Therapy

Sprout Therapy is a tech-forward provider of pediatric behavioral health services across the United States. We believe that families, clinicians and insurers all deserve a modern, comprehensive, and data driven behavioral health platform, so we built one.

Backed by over $96mm from leading investors in healthcare technology, including General Catalyst, Founders Fund, SignalFire, e.ventures, 8VC, Felicis Ventures, Sound Ventures, and Bling Capital, our mission is to provide personalized, technology-empowered behavioral health care for children 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 behavioral health care for children.

About the Role:

Join the New Ventures team and find yourself at the forefront of Sprout?s expansion strategy. At New Ventures, we are building new pediatric behavioral health businesses within Sprout, so that we can deliver our families the care they need across a broad variety of conditions and circumstances.

The Credentialing Specialist will be responsible for timely submission and follow up for organizational and individual provider credentialing and contracting activities with health insurance payors. Sprout Therapy is a rapidly growing organization with continued growth throughout the national market which requires ongoing payor contracting and clinical credentialing enrollments. This role will support Sprout?s New Ventures team to expand into various pediatric behavioral health verticals.

We are looking for an experienced Credentialing Specialist, preferably with experience in Behavioral Health. The ideal candidate will have knowledge of medical billing, payer contracting protocols and clinical staff credentialing and is able to thrive in a fast-paced environment.

What You will Do:
? Contact providers and assist them through the credentialing process with both commercial and Medicaid Networks, following up on missing documents to ensure completion of credentialing process.
? Monitor Staff credentials and Licensure.
? Prepare and submit credentialing applications and supporting documentation for the purpose of enrolling providers with commercial and Medicaid Networks.
? Follow up on the status of applications for providers and payers, tracking progress on all pending and completed work.
? Submit EFT and ERA applications ensuring electronic payments are received from payers.
? Review billing to ensure meeting payer requirements and assist in the quality assurance review process.

What You will Need:
? Minimum two years of health insurance credentialing experience preferred
? Experience in Behavioral Health (Preferred)
? Experience in Behavioral Health Billing process (Preferred)
? Certified Provider Credentialing Specialist (CPCS) Preferred
? Ability to work independently, set priorities and meet deadlines with a strong sense of urgency
? Ability to communicate effectively with all departments, clients, and insurance contacts
? Skilled in Microsoft Office and/or Google Workspace and database programs
? Strong Attention to detail
? Excellent Customer Services skills

About Sprout

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 families. 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 families. 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 throughout the world, including in the following cities: San Francisco, New York, Los Angeles, Miami, 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:
? Families first, everything else second: We put our families 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.
? 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.

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.

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.

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