Job Description

Job Description

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 accounts
• 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 Details: 100% in office position Dallas, TX, M-F, 8am-5pm

About the Role:

Clinical Order Management Specialist is responsible for performing all tasks and communication related to intake and processing of prescriptions and/or physician orders, as well as patient information concerning durable medical equipment. This role regularly communicates with patients, health care providers, Team Members, Health Insurance (payor) representatives and referral sources. The Clinical Order Management Specialist coordinates with DME vendors, physicians, and applicable internal/external personnel regarding medical records and information needed to process orders that are placed by physicians. Confirm medical records meet medical necessity based on applicable insurance guidelines. Promptly follow-up on patient referrals, physician prescriptions and/or physician work orders

In this role, you will be responsible for:

• Assist with appeals for Prior Authorization denials.
• Place orders for Durable Medical Equipment, Diagnostic Imaging and Specialty Drugs.
• Review “Delivery Tickets” to confirm they were completed accurately and signed.
• Perform data entry to supplement orders including patient demographics, prescribing physician’s information, insurance payor information, HCPCS procedure codes, ICD-10 diagnosis codes, etc.
• Regularly contact and communicate with Team Members, insurance companies, vendors, sales representatives, doctor’s offices, practitioners, clearinghouses, billers, and other applicable companies and associates. Send updates on prior authorizations, claims, patient benefits, orders, and other information as appropriate.
• Expert on insurance coverage with all vendors.
• Answer incoming phone calls to office and route messages accordingly.
• Perform detailed notetaking with high accuracy on pertinent information.
• Utilize Adobe Acrobat Pro to create and edit PDF files: insert/move/delete pages; edit/add/redact text; save meta data, create templates, export/import data through plugin, etc.
• Consistently follow up with patients to confirm patient satisfaction.
• Accurately complete forms/applications and send out to applicable destination.
• Exercise patience and empathy when communicating with patients and customers.
• Be aware of and adapt to changes in medical regulations and processes.

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
• Communication: The ability to speak, write, and listen clearly and consistently
• Teamwork: Demonstrates the ability to pull people together into highly effective teams along with ability to work in a highly matrixed organization
• Critical Thinking: Demonstrates the ability to be proactive, anticipate needs; ability to make good decisions with incomplete, ambiguous information
• Adaptability: Demonstrates flexibility and a willingness to change as circumstances evolve and be coachable
• Resourceful: Proactive willingness to utilize available information and tools to figure things out, not afraid to ask questions when necessary
• Self-Motivated: Proactively jumps in to start a task or project with limited direction; asks to take on more responsibility and what is next
• 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

Knowledge:

• High School Diploma
• Medical Assistant Certification
• Knowledge of medical terminology

Experience:

• 2-3 years as a certified medical assistant within a clinic or hospital setting
• Extensive organizational and task management experience
• Electronic Medical Records experience

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. 

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