PN Account Specialist

Cook Children's Health Care System • Fort Worth, TX

1d • Onsite

About The Position

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.

Requirements

• 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
• Proven track record of writing and submitting appeals to get claim denials overturned

Nice To Haves

• Medical terminology preferred
• Professional billing experience in a Pediatric environment preferred
• Epic experience preferred

Responsibilities

• 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
• Maintain a professional demeanor to assure that guests are treated in an appropriate, professional and compassionate manner

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED