PN Account Specialist II
PN Account Specialist II
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Not Disclosed
Salary Not Disclosed
1 Vacancy
Job Description
Location:
Calmont Operations BuildingDepartment:
CBO/PT Financial ServicesShift:
First Shift (United States of America)Standard Weekly Hours:
40Summary:
The Account Specialist II Insurance FollowUp & Denials Management is responsible for all insurance followup responsibilities for Cook Childrens Physician Network. Primary duties are followups analysis and resolution of outstanding insurance claims; initiation of the appeals process on behalf of CCPN providers. The Account Specialist II Insurance FollowUp & Denials Management will primarily be responsible for performing duties such as; reimbursement analysis; provides the Manager Insurance FollowUp & Denials Management with timely financial and volume data related to claims adjudication and payment trend analyses; performs all required patient account adjustments; provides feedback to practice managers regarding effectiveness of diagnostic and procedural coding; monitors active accounts receivable for identification of potential problems; serves as liaison between assigned practices and billing office; communicates effectively with patients practice managers physicians and others regarding collection of outstanding claims; maintains proper documentation and edits of work performed; and at all times maintains a professional demeanor to assure that patients are treated in an appropriate and compassionate manner.
Schedule:
MonFri 7:30am5:30pm
Qualifications:
High School or equivalent required
Intermediate knowledge of coding and medical terminology with understanding of diversified health insurance plans a plus
At least 3 years experience in a physician billing environment or at least two 2 years in the capacity of PN Account Specialist I with proficiency in performance of duties evidenced by a minimum rating of meets expectations on the most recent Performance Review
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. Medical terminology preferred Prior experience with Epic Resolute Professional Billing preferred
About Cook Childrens:
Our notforprofit 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 topranked specialty programs and network of services to meet the unique needs of their child. Cook Childrens is honored to continually receive recognition for our outstanding efforts and outcomes in pediatric health care.
At Cook Childrens were more than a health care systemwere your friends neighbors and even family members. And were parents too so we can see the world through your eyes. We see what youre going throughand how we can help you and your child get the best care and support possible.
Cook Childrens is an EOE/AA Minority/Female/Disability/Veteran employer.
Required Experience:
Unclear Seniority
Employment Type
Full-Time
