Insurance Follow-Up & Denials Specialist II

Cook Children's; Fort Worth (TX); On-site; USD 28,000 - 39,000; Full time

Job summary

Cook Children's in Fort Worth, TX seeks an Account Specialist II in Insurance Follow-Up & Denials Management to manage follow-up and resolution of outstanding claims. You will analyze reimbursements, prepare data on claims adjudication and payment trends, and support practice managers with denial recovery strategies.

Responsibilities include communicating with patients, practices, and physicians, maintaining documentation, and ensuring compliant, compassionate service while enhancing revenue

Qualifications

• High School or equivalent required.
• At least 3 years experience in a physician billing environment or at least two years as PN Account Specialist I.
• Understanding of managed care contracts, denials and payor methodology.
• Prior experience with Epic Resolute Professional Billing preferred.

Responsibilities

• Follow-up, analysis, and resolution of outstanding insurance claims.
• Initiation of the appeals process on behalf of CCPN providers.
• Provide timely financial and volume data related to claims adjudication and payment trends.
• Liaise between practice(s) and billing office; communicate with patients and physicians regarding collection of outstanding claims.

Skills

Physician billing

Third party reimbursement

Communication

Medical terminology

Epic Resolute

Coding basics

Education

High School diploma

Tools

Epic Resolute Professional Billing

Job description

Cook Children's in Fort Worth, TX seeks an Account Specialist II in Insurance Follow-Up & Denials Management to manage follow-up and resolution of outstanding claims. You will analyze reimbursements, prepare data on claims adjudication and payment trends, and support practice managers with denial recovery strategies.

Responsibilities include communicating with patients, practices, and physicians, maintaining documentation, and ensuring compliant, compassionate service while enhancing revenue