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 is a not-for-profit, nationally recognized pediatric health care organization comprised of eight entities – a Medical Center, Physician Network, Home Health company, Northeast Hospital, Pediatric Surgery Center, Health Plan, Health Services Inc., and Health Foundation.Cook Children's Medical Center Based in Fort Worth, Texas, the integrated system has more than 60 primary and specialty care offices throughout North Texas. Its service region includes Denton, Hood, Johnson, Parker, Tarrant and Wise counties, with an additional referral area encompassing nearly half the state.Cook Children's traces its roots back to 1918, but throughout its continual change and robust growth, it still embraces an inspiring promise – to improve the health of every child in its region through the prevention and treatment of illness, disease and injury. To live up to this promise, Cook Children's combines the art of caring with the use of leading technology and extraordinary collaboration to provide exceptional care for every child, every day.History – Cook Children's has a rich history of nearly a century of caring for children.Our Promise – Knowing that every child's ...life is sacred, it is the promise of Cook Children's to improve the health of every child in our region through the prevention and treatment of illness, disease and injury.Companies – Based in Fort Worth, Texas, Cook Children's is a not-for-profit organization that is comprised of eight nationally recognized companies.Community Health Outreach – Cook Children's Community Health Outreach works together with over 150 partner organizations to improve the safety and health of at-risk children through education, disease and injury prevention and support.Clinical Research – Cook Children's is home to a skilled team of research-minded physicians, nurses and health care professionals and administrators who drive our commitment to excellent clinical care and the search for medical advances.Public Relations – Cook Children's Public Relations works with national and local media outlets, produces Cook Children's publications, coordinates special events and helps develop key relationships within the community.Contractor & Vendor Information – Cook Children's contractors and vendors must ensure their employees are knowledgeable about working with our organization.Sponsorship guidelines – Cook Children's sponsors a select number of events that are strongly aligned with its promise to improve the health of every child in the region through the prevention and treatment of illness, disease and injury.