Insurance Claims Follow-up
Found in: Talent US C2 - 1 day ago
Summary:
The Account Specialist II / Insurance Claims Follow-up is primarily responsible for all insurance follow-up responsibilities for the Cook Children's Physician Network. Primary duties include follow-up, analysis, and resolution of outstanding insurance claims, and initiation of the appeals process on behalf of CCPN providers. Will perform duties such as reimbursement analysis; providing updates to 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 the effectiveness of diagnostic and procedural coding; monitors active accounts receivable for identification of potential problems; serves as a 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.
Note: This is a remote position but will require 1-2 weeks of training in Fort Worth (candidates must live in Texas)
Required Education/Experience:
High School or equivalent required.
At least 3 years' experience in a physician billing environment or at least two (2) years in the capacity of Account Specialist I with a satisfactory performance record.
Intermediate knowledge of coding and medical terminology with an understanding of diversified health insurance plans a plus.
Strong 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 is preferred.
Prior experience with Epic Resolute Professional Billing preferred.
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