Location:
Calmont Operations BuildingDepartment:
CBO/Patient Financial ServicesShift:
First Shift (United States of America)Standard Weekly Hours:
40Summary:
Under the direction of the Director of Revenue Cycle, the Insurance Follow-Up & Denials Manager is responsible for managing hospital accounts receivable for Government (Medicaid, Medicare and Government Managed Care) payors through claim follow up, cash collection, and denial prevention. The Manager is to organize and coordinate the reimbursement and accounting of patient accounts in accordance with departmental and organization objectives, policies and procedures. This position operates independently and directly supervises all follow-up/collection staff. The Insurance Follow-Up & Denials Manager requires complex data analysis and makes independent decisions within the scope of responsibility. Major decisions are subject to approval of the Director. Internal contacts consist of all levels of staff and management throughout Cook Children’s Health Care System (CCHCS). External contacts consist of patients and their families, insurance companies, physicians and their staff, state and federal agencies, auditors, and vendors. Contacts are for the purpose of resolving issues and discussing sensitive and confidential information with all contact levels.
Qualifications:
High School Diploma or equivalent required.
Bachelor’s degree in business, Accounting, Finance or related field preferred
Minimum five years’ experience in hospital accounts receivable experience
Three plus years of progressive supervisory / management experience
Knowledge / Skills / Abilities:
Apply appropriate management and leadership techniques in an operational setting
Work independently and take initiative
Ability to deal effectively with constant changes and be a change agent
Interact and communicate both verbally and in writing with all levels of associates, management and customers in Healthcare / Business
Extensive knowledge of state, federal and compliance regulations as they pertain to insurance claim processing and third-party reimbursement
Detailed knowledge of diversified insurance plans including Medicare, Medicaid and commercial payors, and claim processing and reimbursement methodologies
Prior experience with Epic Systems Revenue Cycle Solutions preferred.
About Us:
Cook Children's Medical Center is the cornerstone of Cook Children's, and offers advanced technologies, research and treatments, surgery, rehabilitation and ancillary services all designed to meet children's needs.
Cook Children's is an EOE/AA, Minority/Female/Disability/Veteran employer.
Skills Required
- High School Diploma or equivalent
- Bachelor's degree in Business, Accounting, Finance or related field
- Minimum five years' hospital accounts receivable experience
- Three plus years of progressive supervisory/management experience
- Extensive knowledge of state, federal and compliance regulations for insurance claim processing and third-party reimbursement
- Detailed knowledge of diversified insurance plans including Medicare, Medicaid and commercial payors and reimbursement methodologies
- Prior experience with Epic Systems Revenue Cycle Solutions
- Ability to apply management and leadership techniques in an operational setting
- Ability to work independently and take initiative
- Strong verbal and written communication skills with all organizational levels
- Ability to manage change and act as a change agent
What We Do
Cook Children's Health Care System embraces an inspiring Promise – to improve the health of every child in our region through the prevention and treatment of illness, disease and injury. Based in Fort Worth, Texas, we’re proud of our long and rich tradition of serving our community.
