PN Account Specialist

Posted 2 Days Ago
Be an Early Applicant
Ops, ND
Mid level
Healthtech
The Role
The Account Specialist is responsible for managing outstanding insurance claims for providers, including contacting payor representatives, documenting work, and initiating appeals as necessary, all while maintaining professional interactions with guests.
Summary Generated by Built In

Location:

Calmont Operations Building

Department:

CBO/PT Financial Services

Shift:

First Shift (United States of America)

Standard Weekly Hours:

40

Summary:

The Account Specialist, Insurance Follow-Up & Denials Management is responsible for initial contact regarding outstanding claims for Cook Children's Physician Network providers. Primary duties include; Claims work queue management, navigating payor websites, contacting claim representatives to determine the status of outstanding insurance claims, initiation of the appeals process on behalf of CCPN providers, maintenance of proper documentation of work performed; and at all times maintain a professional demeanor to assure that guests are treated in an appropriate, professional and compassionate manner.
Education:

  • High School or equivalent required.

  • Three years' experience in a business office setting is required.

  • Basic knowledge of coding and medical terminology with understanding of diversified health insurance plans, managed care contracts, denials and payor methodology a plus.

  • Medical terminology preferred.

About Cook Children’s:

Our 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.

The Company
HQ: Fort Worth, TX
5,001 Employees
On-site Workplace
Year Founded: 1918

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.

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