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Billing Specialist, Denials Management - Brentwood, TN, United States - Sound Physicians
Description
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.
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
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.
Auditing denial adjustment requests from billing vendors, field operations and Sound Physician staffWorking closely with Regional Operations, Contracting, Coding, Compliance, Payers, Billing companies and the Denials Committee to address issues affecting appropriate reimbursement
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
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
Relationship Building and Maintenance:
The ability to create and nourish healthy, strong relationships, as the face of Sound
Commitment - Demonstrates a dedication to the job, project, organization, customer/clients, and co-workers
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
3-5 years' experience in medical insurance authorization, billing, patient accounts or related role required
Experience in denial and claims resolution required
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.
