Pediatric Claims Follow-Up & Denials Specialist

Cook Children's Health Care System; Fort Worth (TX); On-site; USD 42,000 - 54,000; Full time

Job summary

Cook Children's Health Care System in Fort Worth, TX, seeks a Physician's Network Account Specialist to manage outstanding claims for CCPN providers. You will handle the claims work queue, navigate payor portals, and contact claim representatives to determine statuses while initiating appeals when needed.

You will maintain thorough documentation, uphold a professional, compassionate demeanor with guests, and collaborate with office staff to ensure accurate billing and timely resolutions.

Qualifications

• High School or equivalent required.
• Three years' experience in a business office setting is required.
• Basic knowledge of coding and medical terminology with understanding of diversified health insurance plans, managed care contracts, denials and payor methodology a plus.
• Medical terminology preferred.

Responsibilities

• Handle initial contact regarding outstanding claims for CCPN providers.
• Manage the claims work queue and navigate payor websites.
• Contact claim representatives to determine status of outstanding claims.
• Initiate appeals on behalf of CCPN providers.
• Maintain documentation of work performed and present a professional demeanor.

Skills

3 years' experience in a business offi

Medical terminology

Payor knowledge

Education

High School or equivalent

Job description

Cook Children's Health Care System in Fort Worth, TX, seeks a Physician's Network Account Specialist to manage outstanding claims for CCPN providers. You will handle the claims work queue, navigate payor portals, and contact claim representatives to determine statuses while initiating appeals when needed.

You will maintain thorough documentation, uphold a professional, compassionate demeanor with guests, and collaborate with office staff to ensure accurate billing and timely resolutions.