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PN Account Specialist II

Company: Cook Children's Health Care System
Location: Fort Worth
Posted on: September 13, 2020

Job Description:

SUMMARY

The Account Specialist II, Insurance Follow-Up & Denials Management is responsible for all insurance follow-up responsibilities for Cook Children's Physician Network. Primary duties are; follow-up, analysis, and resolution of outstanding insurance claims; initiation of the appeals process on behalf of CCPN providers. The Account Specialist II, Insurance Follow-Up & Denials Management will primarily be responsible for performing duties such as; reimbursement analysis; provides the Manager, Insurance Follow-Up & 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 practice(s) 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.

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.

#ZR.

Cook Children's is an EOE/AA, Minority/Female/Disability/Veteran employer.

Keywords: Cook Children's Health Care System, Fort Worth , PN Account Specialist II, Other , Fort Worth, Texas

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