Account Specialist II

Cook Children's Health Care SystemFort Worth, TX
Onsite

About The Position

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 Children's Medical Center (CCMC). This position 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.

Requirements

  • High School Diploma or equivalent required
  • 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

Nice To Haves

  • Bachelors preferred
  • Medical terminology preferred
  • Prior experience with Epic Hospital Billing Resolute preferred

Responsibilities

  • Claim follow up
  • Cash collection
  • Denial management
  • Root cause analysis and resolution of denial and variance records
  • Triage and resolve payor denials
  • Review and adjudicate insurance credit balances

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What This Job Offers

Job Type

Full-time

Career Level

Mid Level

Education Level

High school or GED

Number of Employees

501-1,000 employees

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