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Insurance Claims Specialist II

2 months ago

Fort Worth, Texas, United States Cook Children's Health Care System Full time
Job Summary

Cook Children's Health Care System is seeking a highly skilled Insurance Claims Specialist II to join our team. As a key member of our insurance follow-up team, you will be responsible for ensuring timely and accurate reimbursement for our patients.

Key Responsibilities
  • Follow up on outstanding insurance claims to ensure timely resolution and reimbursement
  • Analyze and resolve complex insurance claims issues
  • Initiate appeals process on behalf of Cook Children's providers
  • Provide timely financial and volume data to management on claims adjudication and payment trends
  • Perform patient account adjustments and maintain accurate records
  • Communicate effectively with patients, practice managers, physicians, and other stakeholders
  • Maintain professional demeanor and provide compassionate care to patients
Requirements
  • High School diploma or equivalent required
  • Intermediate knowledge of coding and medical terminology
  • Understanding of diversified health insurance plans
  • At least 3 years experience in a physician billing environment or 2 years as a PN Account Specialist I
  • Proficiency in Epic Resolute Professional Billing preferred
About Cook Children's

Cook Children's is a not-for-profit organization providing comprehensive healthcare services to children and families. Our system includes a medical center, physician network, home health company, surgery centers, health plan, health services, and health foundation. We are committed to delivering exceptional patient care and outcomes.