What are the responsibilities and job description for the Account Specialist II position at CCMC Cook Children's Medical Center?
Location: Calmont Operations Building Department: CBO/Patient Financial Services Shift: First Shift (United States of America) Standard Weekly Hours: 40 Summary: Under the leadership of Patient Financial Services (PFS) management, the Account Specialist II is responsible for accounts receivable through claim follow up, cash collection, and denial management for services rendered by Cook Children's Medical Center (CCMC). This position requires extensive knowledge of Federal, State, and payor regulations, reimbursement methodologies, and communication with third party payers to facilitate timely and accurate reimbursement. Perform root cause analysis and resolution of denial and variance records. Triage and resolve payor denials. Review and adjudicate insurance credit balances. Qualifications: High School Diploma or equivalent required - Bachelors preferred Minimum three years billing, insurance follow-up, or healthcare business office experience 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 Keyboarding accuracy and math aptitude skills Medical terminology preferred Prior experience with Epic Hospital Billing Resolute 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. Promise, a strong word with deep meaning that everyone understands—especially kids. This is the foundation of our organization and what drives us to blaze new trails in medical care, research, advanced technology, as well as programs and initiatives that benefit children who may not otherwise have access to quality health care. Every day our employees come to work with the intention of keeping our Promise. It's the guiding principle that helps our patients and their families get better and stay healthy. As a member of our Cook Children's team, you can be an important part of making that happen. Please, create a profile and upload your resume/CV by clicking the Get Started button.