What are the responsibilities and job description for the Billing Specialist, Denials Management - Temporary Position position at 10046 Sound Inpatient Phys Inc (SIP)?

Job Description

About Sound :

Headquartered in Tacoma, WA, Sound Physicians is a physician-founded and led, national, multi-specialty medical group made up of more than 1,000 business colleagues and 4,000 physicians, APPs, CRNAs, and nurses practicing in 400-plus hospitals across 45 states. Founded in 2001, and with specialties in emergency and hospital medicine, critical care, anesthesia, and telemedicine, Sound has a reputation for innovating and leading through an ever-changing healthcare landscape — with patients at the center of the universe.

Sound Physicians offers a competitive benefits package inclusive of the items below, and more :

Medical insurance, Dental insurance and Vision insurance
Health care and dependent care flexible spending account
401(k) retirement savings plan with a company match
Paid time off (PTO) begins accruing immediately upon start date at a rate of 15 days per year, in accordance with Sound's PTO policy
Ten company-paid holidays per year

About the Role :

The Denials Management Billing Specialist is responsible for following payor guidelines, legislation and regulations. They are responsible to track, trend and provide root cause analysis of denials received by payors. The Specialist works to eliminate denials allowing the organization to realize a decrease in the volume of denied accounts and dollars. Candidates should have experience with a minimum of one of our core service lines.

The Details : This is a full-time, 40-hour / week temporary contract role that offers a hybrid work schedule, requiring some on-site presence in Brentwood, TN, along with the flexibility for remote work.

In this role, you will be responsible for :

Auditing denial adjustment requests from billing vendors, field operations and Sound Physician staff

Working closely with Regional Operations, Contracting, Coding, Compliance, Payers, Billing companies and the Denials Committee to address issues affecting appropriate reimbursement

Researching and analyzing denial trending and root cause by payer and region. Compiling data on inappropriate high volume denial types and working with payors, contracting and billing companies to resolve

Maintaining documentation and participating in external audits in order to validate compliance with Sound Physicians policies surrounding denial adjustment requests

Participating in Denials Management Committee meetings and providing feedback on areas requiring improvement for denials resolution

Reviewing, working and trending vendor escalations

Reviewing denial and payer trends for resolution

Partnering with vendor to resolve denial and unpaid claims

Reconciling approved adjustments to ensure that they have been posted and closed in the billing system timely, ensuring aging buckets do not increase

Assisting department leadership with ad-hoc reports, research, analysis and special projects

Managing time effectively to complete assignments within established time frames, optimizing collections, and meeting performance goals

Other duties as assigned

What we are looking for :

A successful candidate will have a demonstrated track record of a combination of these values, knowledge, and experience :

Values :

Work Ethic – Dedication to getting the job done well and on time, regardless of circumstances, a can-do attitude

Can-do” Attitude : Proactively seeks assignments, solutions and takes action where and as needed

Coachability : Demonstrates a willingness to accept feedback from others and put it into practice

Customer-focus : Puts customer (internal and external) needs first and makes customers their top priority

Eagerness to Learn : Proactively seeks out information, embraces learning new things and enjoys the learning process

Teamwork : Proactively seek to work with others to accomplish a common goal. Willingness to share challenges and successes with others

Adaptability : Demonstrates flexibility and a willingness to change as circumstances evolve and be coachable

Resourcefulness : Proactive willingness to utilize available information and tools to figure things out, not afraid to ask questions when necessary

Commitment : Demonstrates a dedication to the job, project, organization, customer / clients, and co-workers

Knowledge :

High school diploma or equivalent required

Advanced understanding / knowledge of computer data entry, Microsoft Excel and ability to navigate through any business related software

Knowledge and skilled in the use of a computers and related systems and software

Maintains current knowledge base for regulations : state, federal, and commercial payors

Experience :

3-5 years’ experience in medical insurance authorization, billing, patient accounts or related role required

Experience in denial and claims resolution required

Pay Range :

This position offers an hourly pay range between $20.00 to $28.00. The starting hourly rate will fall between $20.00 and $26.00, considering the candidate’s experience and location.

Sound Physicians is an Equal Employment Opportunity (EEO) employer and is committed to diversity, equity, and inclusion at the bedside and in our workforce. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, gender identity, sexual orientation, age, marital status, veteran status, disability status, or any other characteristic protected by federal, state, or local laws.

This job description reflects the present requirements of the position.  As duties and responsibilities change and develop, the job description will be reviewed and subject to amendment.

Salary : $20 - $28

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Billing Specialist, Denials Management - Temporary Position

What are the responsibilities and job description for the Billing Specialist, Denials Management - Temporary Position position at 10046 Sound Inpatient Phys Inc (SIP)?

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