Contract - Billing & Denials Management Specialist

Sound Physicians; Brentwood (TN); Remote; USD 45,000 - 60,000; Full time

Job summary

A leading healthcare organization is seeking a Denials Management Billing Specialist to manage and analyze claims denials. This role involves working closely with vendors and insurance companies to resolve issues and improve reimbursement processes. The ideal candidate will have strong analytical skills and a commitment to customer service, with a focus on teamwork and adaptability. This is a full-time temporary remote position starting June 2025.

Qualifications

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

Customer-focus

Adaptability

Education

High school diploma or equivalent

Tools

Microsoft Excel

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.

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

Equal Opportunity Employer
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