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:

Under supervision of the Senior Director of Payer Enrollment & Credentialing, serves as the Payer Credentialing Manager to ensure payer credentialing applications are submitted to insurance carriers in a timely manner. This position provides a proactive interface between the provider, third party vendors, and the carrier and is integral to company’s revenue cycle.

The Details: This is a virtual, work-from-home role.

In this role, you will be responsible for:

Collaborating with department leadership on the development and maintenance of department processes and policies as needed
Maintaining a working knowledge of enrollment requirements of various health plans for multiple states
Serving as point-of-contact for escalated issues involving Payer Enrollment and communicating directly with payer representatives to resolve enrollment issues
Overseeing third party vendor resources involved in daily payer enrollment activities
Responding to unusual problems or delays in enrollment process (including claim denials)
Reviewing, updating and analyzing the provider enrollment reports from third party vendor weekly and reporting concerns and progress to the Senior Director
Providing training to internal team and external vendor staff on payer enrollment processes and utilization of technology resources as needed
Creating Write-Off Justifications and maintaining/updating spreadsheets as needed
Responding to unbilled problems as indicated by “holding report”
Submitting monthly rosters for associated delegated credentialing contracts for commercial payers
Providing regular evaluation of work product produced by third party vendor to the Senior Director to validate service level agreement compliance
Compiling reports and workbooks as needed
Completing assigned departmental audits
Directing and distributing special projects
Assessing daily/weekly workload of third-party resources and distributing based on volume
Leading weekly meetings with third party vendors– ensuring all functions are being completed in a timely manner
Providing cross coverage for other departmental leadership in their absence
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:

Resourceful: Proactive willingness to utilize available information and tools to figure things out
Adaptable: Demonstrates flexibility and a willingness to change as circumstances evolve
Collaborative: Demonstrates the ability to work well with others to accomplish a goal and get the work done; takes opinions of others into consideration; includes others in the decision-making process
Intellectually curious: Demonstrates a genuine interest in learning new things and wants to know the reason “why” behind the way things are done
Passionate: Demonstrates a genuine enthusiasm for and excitement about the work; gets others excited about work or projects they're involved in and working on
Strategic thinker: Demonstrates the ability to look at the big picture and proactively develop a plan of action
Teamwork: Demonstrates the ability to pull people together into highly effective teams along with ability to work in a highly matrixed organization
Communication: The ability to speak, write, and listen clearly and consistently
Relationship Building and Maintenance: The ability to create and nourish healthy, strong relationships, as the face of Sound

Knowledge:

High School Diploma or Equivalent
Proficiency with Microsoft Office Suite
Working knowledge of provider enrollment structure and processes
Excellent organization abilities
Excellent written and oral communication skills

Experience:

Minimum 2-5 years’ experience in medical insurance, credentialing, payer enrollment or related field
Minimum 2 years in leadership role, with direct supervisory experience
Required: Advanced understanding/knowledge of computer data entry, Microsoft Excel and ability to navigate through any business related software

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.

Sound Physicians jobs

Payer Enrollment Manager -Remote