Account Specialist II

Account Specialist II

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.