Account Specialist II

CCPN Cook Children's Physician Network; Fort Worth (TX); On-site; USD 42,000 - 54,000; Full time

Job summary

Cook Children's Medical Center in Fort Worth, TX seeks an Account Specialist II to manage accounts receivable through claim follow-up, cash collection and denial management for services rendered. You will perform root cause analysis and resolve payor denials, while reviewing insurance credit balances.

Requirements include at least three years in billing or healthcare business office, strong communication skills, and knowledge of managed care contracts and payor methods.

Qualifications

• Minimum three years billing, insurance follow-up, or healthcare business office experience.
• Understanding of Managed Care contracts, denials and payor methodology.
• Extensive knowledge of healthcare third party reimbursement, variance and denial records.
• Effective oral and written communication skills.
• Prior experience with Epic Hospital Billing is preferred.

Responsibilities

• Manage accounts receivable through claim follow-up, cash collection and denial management for CCMC services.
• Perform root cause analysis and resolution of denial and variance records.
• Triage and resolve payor denials.
• Review and adjudicate insurance credit balances.

Skills

Billing & follow-up

Effective communication

Medical terminology

Epic Hospital Billing

Education

High School Diploma

Bachelor's degree preferred

Tools

Epic Hospital Billing

Resolute

Job description

Location: Medical Center - Fort Worth Department: CBO/PT Financial Services Shift: First Shift (United States of America) Standard Weekly Hours: 40

Summary: Under the leadership of Patient Financial Services (PFS) management, the Account Specialist II is responsible for accounts receivable through claim follow up, cash collection, and denial management for services rendered by Cook Childrens Medical Center (CCMC). This positon requires extensive knowledge of Federal, State, and payor regulations, reimbursement methodologies, and communication with third party payers to facilitate timely and accurate reimbursement. Perform root cause analysis and resolution of denial and variance records. Triage and resolve payor denials. Review and adjudicate insurance credit balances.

Education:

High School Diploma or equivalent. Bachelors preferred

Requirements:

Minimum three years billing, insurance follow-up, or healthcare business office experience Understanding of Managed Care contracts, denials and payor methodology Extensive knowledge of healthcare third party reimbursement, variance and denial records Effective oral and written communication skills Keyboarding accuracy and math aptitude skills Medical terminology preferred Prior experience with Epic Hospital Billing Resolute preferred

Certification/Licensure:

About Cook Children’s: Our not-for-profit organization is comprised of a flagship medical center in Fort Worth, Texas, a new medical center in Prosper, Texas, a physician network, home health company, surgery centers, health plan, health services, and health foundation. With more than 60 primary, specialty and urgent care locations throughout Texas, families can access our top-ranked specialty programs and network of services to meet the unique needs of their child. Cook Children's is honored to continually receive recognition for our outstanding efforts and outcomes in pediatric health care. At Cook Children's, we're more than a health care system––we're your friends, neighbors and even family members. And we're parents too, so we can see the world through your eyes. We see what you're going through––and how we can help you and your child get the best care and support possible. Cook Children’s is an equal opportunity employer. As such, Cook Children’s offers equal employment opportunities without regard to race, color, religion, sex, age, national origin, physical or mental disability, pregnancy, protected veteran status, genetic information, or any other protected class in accordance with applicable federal laws. These opportunities include terms, conditions and privileges of employment, including but not limited to hiring, job placement, training, compensation, discipline, advancement and termination. Cook Children’s is a Texas-only employer. If you are hired, you will need to maintain your primary residence within the state of Texas, along with all licenses and credentials required for your position throughout your employment. Promise, a strong word with deep meaning that everyone understands—especially kids. This is the foundation of our organization and what drives us to blaze new trails in medical care, research, advanced technology, as well as programs and initiatives that benefit children who may not otherwise have access to quality health care. Every day our employees come to work with the intention of keeping our Promise. It's the guiding principle that helps our patients and their families get better and stay healthy. As a member of our Cook Children's team, you can be an important part of making that happen.