Account Specialist II

Job description

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 apt...