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; and at all times maintain a professional demeanor to assure that guests are treated in an appropriate, professional and compassionate manner.
Education & Experience
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.