PN Account Specialist

Cook Children's Health Care System; Fort Worth (TX); Vor Ort; USD 52.000 - 76.000; Vollzeit

Zusammenfassung

Cook Children's Health Care System is seeking an Account Specialist in Insurance Follow-Up & Denials Management to handle outstanding claims for CCPN providers. You will manage the claims work queue, navigate payor websites, and contact claim representatives to determine claim status.

You will initiate appeals on behalf of CCPN providers and maintain accurate documentation while delivering professional, compassionate service to guests and colleagues.

Qualifikationen

• 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.
• Proven track record of writing and submitting appeals to get claim denials overturned.
• Professional billing experience in a Pediatric environment preferred.
• Epic experience preferred.

Aufgaben

• Manage claims work queue and follow up on outstanding insurance claims.
• Navigate payor websites and contact claim representatives to determine status of claims.
• Initiate appeals process on behalf of CCPN providers.
• Maintain proper documentation of work performed and provide professional, compassionate service.

Kenntnisse

Denials management

Medical terminology

Coding knowledge

Epic experience

Ausbildung

High School or equivalent

Tools

Epic

Jobbeschreibung

Summary

The Account Specialist, Insurance Follow-Up & Denials Management is responsible for initial contact regarding outstanding claims for Cook Children's Physician Network providers. Primary duties include; Claims work queue management, navigating payor websites, contacting claim representatives to determine the status of outstanding insurance claims, initiation of the appeals process on behalf of CCPN providers, maintenance of proper documentation of work performed; and at all times maintain a professional demeanor to assure that guests are treated in an appropriate, professional and compassionate manner.

Location

Calmont Operations Building

Department

CBO/PT Financial Services

Shift

First Shift (United States of America)

Standard Weekly Hours

40

Education & Experience

• 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.
• Proven track record of writing and submitting appeals to get claim denials overturned. Professional billing experience in a Pediatric environment preferred. Epic experience preferred.

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.