Location:
Calmont Operations Building
Department:
CBO/PT Financial Services
Shift:
First Shift (United States of America)
Standard Weekly Hours:
40
Summary:
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 Childrens Medical Center (CCMC). This positon 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.
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Qualification:
- High School Diploma or equivalent. Bachelors preferred
- 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
- Medical terminology preferred
- Prior experience with Epic Hospital Billing Resolute preferred
About Cook Children's:
• ur 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 EOE/AA, Minority/Female/Disability/Veteran employer.