The Manager, Insurance Follow-Up & Denials Management is responsible for daily management and oversight of insurance claim follow-up, denial management and appeal dispute functions for physicians to assure the health of accounts receivable and maximize reimbursement. The Manager, Insurance Follow-Up & Denials Management is responsible for evaluating analytical reporting trends, examining and re-engineering operations and procedures related to key performance indicators, and implements new strategies and procedures to achieve objectives. The Manager, Insurance Follow-Up & Denials Management is responsible for the creation, implementation and enforcement of directives, solutions and all billing related policies and procedures that emphasize "best practices". The Manager, Insurance Follow-Up & Denials Management is required to manage multiple projects involving a high level of facilitation with third party payers, CCHCS Payor Relations, Revenue Integrity, and other team partners to achieve payment resolution. The Manager, Insurance Follow-Up & Denials Management serves as a resource to primary care, specialty care, UCC, physicians and practice managers to provide assistance with problem solving claim issues/edits, answer questions regarding CCPN programs by developing and sustaining open communications between the CBO and practice managers.
High School Diploma required. College degree preferred.
At least five years' experience in a healthcare environment, with a minimum of three years supervisory or management experience in a billing office environment.
Extensive knowledge of physician billing including allowance schedules, coding concepts and current applicable computer technology.
Understanding of diversified insurance plans and reimbursement methodologies.
Exhibit good interpersonal and communication skills.
Maturity to withstand pressure that may arise in relation to the public, physician or administration.
Proficiency with Microsoft Office products including Excel, PowerPoint and Word.
Internal Number: 38305
About Cook Children's Health Care System
Cook Children's Health Care System embraces an inspiring Promise – to improve the health of every child in our region through the prevention and treatment of illness, disease and injury. Based in Fort Worth, Texas, we’re proud of our long and rich tradition of serving our community.