Contract - Billing & Denials Management Specialist

Sound Physicians, Inc.; Brentwood (TN); Remote; USD 50,000 - 70,000; Full time

Job summary

A leading healthcare organization is seeking a Denials Management Billing Specialist to manage payor guidelines and reduce denial volumes. This full-time remote role requires strong analytical skills and experience in medical billing. Join a dynamic team focused on improving healthcare operations.

Qualifications

• 3-5 years’ experience in medical insurance authorization, billing, or related role required.
• Advanced understanding of computer data entry and business-related software.

Responsibilities

• Track, trend, and analyze denials received by payors.
• Contact insurance companies to resolve unpaid claims.
• Participate in Denials Management Committee meetings.

Skills

Work Ethic

Can-do Attitude

Coachability

Customer-focus

Eagerness to Learn

Teamwork

Adaptability

Resourcefulness

Education

High school diploma or equivalent

Tools

Microsoft Excel

Job description

Job Category: FINANCE, ACCOUNTING AND REVENUE CYCLE OPERATI

Requisition Number: BILLI005145

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• Posted : May 14, 2025
• Full-Time
• Remote

Locations

Showing 1 location

OFCBRT Office - Brentwood
5410 Maryland Way, Suite 300
Brentwood, TN 37027, USA

OFCBRT Office - Brentwood
5410 Maryland Way, Suite 300
Brentwood, TN 37027, USA

OFCPAP XXXOffice - Tacoma
1250 Pacific Avenue, Suite 702
Tacoma, WA 98402, USA

OFCPAP XXXOffice - Tacoma
1250 Pacific Avenue, Suite 702
Tacoma, WA 98402, USA

OFCCHI Office - Chicago
401 S Lasalle St
Suite 1401
Chicago, IL 60605, USA

OFCCHI Office - Chicago
401 S Lasalle St
Suite 1401
Chicago, IL 60605, USA

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.

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. (Emergency, Critical Care, Anesthesia, Hospitalist Medicine)

The Details:Full-time temporary contract starting June 2025 - February 2026, Remote WFH, daytime hours M-F

In this role, you will be responsible for:

• Review, work, and trend vendor claim escalations.
• Partner with vendor to resolve denials and unpaid claims.
• Contact Insurance companies to resolve unpaid claims
• Audit denial adjustment requests from billing vendors, field operations and Sound Physician staff.
• Work closely with leadership to address issues affecting appropriate reimbursement.
• Research and analyze denial trending and root cause by payer and region. Compile data on inappropriate high volume denial types and work with payors, contracting, and billing companies to resolve.
• Maintain documentation and participate in external audits to validate compliance with Sound Physicians policies surrounding denial adjustment requests.
• Participate in Denials Management Committee meetings and provide feedback on areas requiring improvement for denials resolution.
• Assist department leadership with ad-hoc reports, research, analysis, and special projects.
• Manage time effectively to complete assignments within established time frames, optimize collections, and meet 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

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.

#SoundBC

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Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.