Account Specialist II

Cook Children's Health Care System; Fort Worth (TX); On-site; USD 42,000 - 64,000; Full time

Job summary

Cook Children’s Health Care System in Fort Worth, TX is seeking an Account Specialist II responsible for accounts receivable functions, claim follow up, and cash collection for services rendered at CCMC. The role requires knowledge of payer regulations and denial resolution to ensure timely reimbursement.

Education includes a High School Diploma or equivalent; a Bachelor's degree is preferred. Prior Epic Hospital Billing experience is preferred.

Qualifications

• 3+ 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
• Strong verbal and written communication skills

Responsibilities

• Manage accounts receivable through claim follow up and cash collection
• Perform denial management and triage payor denials
• Review and adjudicate insurance credit balances
• Maintain knowledge of Federal, State, and payer regulations and reimbursement methodologies
• Communicate with third party payers to facilitate timely reimbursement

Skills

Accounts receivable

Insurance follow-up

Denial management

Communication skills

Education

High School Diploma or equivalent

Bachelor's degree preferred

Tools

Epic Resolute

Epic Hospital Billing

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 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.

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.

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.