PN Account Specialist

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 workqueue 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. At all times the specialist must 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.

Certification / Licensure:

(If applicable)

Equal Employment Opportunity Statement:

Cook Children’s is an equal opportunity employer. As such, Cook Children’s offers equal employment opportunities without regard to race, color, religion, sex, age, national origin, physical or mental disability, pregnancy, protected veteran status, genetic information, or any other protected class in accordance with applicable federal laws. These opportunities include terms, conditions, and privileges of employment, including but not limited to hiring, job placement, training, compensation, discipline, advancement and termination.

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