Account Representative jobs at Covenant Health System

Below covers everything you need to know about what this opportunity entails, as well as what is expected from applicants. Performs a variety of complex administrative duties for patients in need of routine and/or urgent appointments, medical procedures, tests, and associated ancillary services in an ambulatory in/outpatient setting. Assess patients' needs, including but not limited to, financial counseling, interpreter services, social services and refers to appropriate person or area. Alerts providers to emergent patient care needs. Responsibilities: Receives and directs phone calls from patients and physician offices Schedules patients for treatment by multiple providers and treatment areas, and arranges a variety of associated tests and procedures according to established guidelines and specific criteria Prioritizes appointments in a manner that fosters optimum patient care, efficient utilization of physician's clinical staff, as well as equipment and facilities Handles urgent patient care calls and may alert providers to emergent patient care symptoms and concerns Schedules urgent care appointments as needed and directed by physician Greets patients for scheduled and/or urgent care appointments and procedures Confirms and verifies patient demographic and insurance information Collect co-payments from patients upon arrival when applicable Obtains signatures of consent from patient/guardian for treatment authorization and insurance/billing information Collaborates with insurers to obtain patients' prior-authorizations for procedures and tests as needed Follows guidelines established by insurers to ensure that pre-authorization, pre-certification, and physician referrals for treatment are obtained prior to patient visits. xevrcyc Verifies eligibility for procedures or tests from various health care institutions Reviews and audits billing discrepancy reports and researches errors for resolution Maintains accurate and timely records, logs, charges, files, and other related information as required Performs a variety of related administrative and clerical duties, such as retrieving files and other records, faxing, collating, data entry, and relaying messages to physicians, residents and staff Prepares special reports or spreadsheets for physicians as requested Complies with established departmental policies, procedures and objectives Complies with all health and safety regulations and requirements Contributes in maintaining a respectful environment of professionalism, tolerance, and acceptance toward all employees, patients and visitors Performs other duties as required. Requirements: High School Diploma or GED Proficient in software and computer systems Knowledgeable of business office terminology / procedures Ability to multi task and work under stressful situation Effective written and verbal communication skills 1+ year of customer service experience required Experience with medical office terminology preferred Work Schedule: 5 Days - 8 Hours Work Type: Full Time

Below covers everything you need to know about what this opportunity entails, as well as what is expected from applicants. Performs a variety of complex administrative duties for patients in need of routine and/or urgent appointments, medical procedures, tests, and associated ancillary services in an ambulatory in/outpatient setting. Assess patients' needs, including but not limited to, financial counseling, interpreter services, social services and refers to appropriate person or area. Alerts providers to emergent patient care needs. Responsibilities: Receives and directs phone calls from patients and physician offices Schedules patients for treatment by multiple providers and treatment areas, and arranges a variety of associated tests and procedures according to established guidelines and specific criteria Prioritizes appointments in a manner that fosters optimum patient care, efficient utilization of physician's clinical staff, as well as equipment and facilities Handles urgent patient care calls and may alert providers to emergent patient care symptoms and concerns Schedules urgent care appointments as needed and directed by physician Greets patients for scheduled and/or urgent care appointments and procedures Confirms and verifies patient demographic and insurance information Collect co-payments from patients upon arrival when applicable Obtains signatures of consent from patient/guardian for treatment authorization and insurance/billing information Collaborates with insurers to obtain patients' prior-authorizations for procedures and tests as needed Follows guidelines established by insurers to ensure that pre-authorization, pre-certification, and physician referrals for treatment are obtained prior to patient visits. xevrcyc Verifies eligibility for procedures or tests from various health care institutions Reviews and audits billing discrepancy reports and researches errors for resolution Maintains accurate and timely records, logs, charges, files, and other related information as required Performs a variety of related administrative and clerical duties, such as retrieving files and other records, faxing, collating, data entry, and relaying messages to physicians, residents and staff Prepares special reports or spreadsheets for physicians as requested Complies with established departmental policies, procedures and objectives Complies with all health and safety regulations and requirements Contributes in maintaining a respectful environment of professionalism, tolerance, and acceptance toward all employees, patients and visitors Performs other duties as required. Requirements: High School Diploma or GED Proficient in software and computer systems Knowledgeable of business office terminology / procedures Ability to multi task and work under stressful situation Effective written and verbal communication skills 1+ year of customer service experience required Experience with medical office terminology preferred Work Schedule: 5 Days - 8 Hours Work Type: Full Time

Below covers everything you need to know about what this opportunity entails, as well as what is expected from applicants. Performs a variety of complex administrative duties for patients in need of routine and/or urgent appointments, medical procedures, tests, and associated ancillary services in an ambulatory in/outpatient setting. Assess patients' needs, including but not limited to, financial counseling, interpreter services, social services and refers to appropriate person or area. Alerts providers to emergent patient care needs. Responsibilities: Receives and directs phone calls from patients and physician offices Schedules patients for treatment by multiple providers and treatment areas, and arranges a variety of associated tests and procedures according to established guidelines and specific criteria Prioritizes appointments in a manner that fosters optimum patient care, efficient utilization of physician's clinical staff, as well as equipment and facilities Handles urgent patient care calls and may alert providers to emergent patient care symptoms and concerns Schedules urgent care appointments as needed and directed by physician Greets patients for scheduled and/or urgent care appointments and procedures Confirms and verifies patient demographic and insurance information Collect co-payments from patients upon arrival when applicable Obtains signatures of consent from patient/guardian for treatment authorization and insurance/billing information Collaborates with insurers to obtain patients' prior-authorizations for procedures and tests as needed Follows guidelines established by insurers to ensure that pre-authorization, pre-certification, and physician referrals for treatment are obtained prior to patient visits. xevrcyc Verifies eligibility for procedures or tests from various health care institutions Reviews and audits billing discrepancy reports and researches errors for resolution Maintains accurate and timely records, logs, charges, files, and other related information as required Performs a variety of related administrative and clerical duties, such as retrieving files and other records, faxing, collating, data entry, and relaying messages to physicians, residents and staff Prepares special reports or spreadsheets for physicians as requested Complies with established departmental policies, procedures and objectives Complies with all health and safety regulations and requirements Contributes in maintaining a respectful environment of professionalism, tolerance, and acceptance toward all employees, patients and visitors Performs other duties as required. Requirements: High School Diploma or GED Proficient in software and computer systems Knowledgeable of business office terminology / procedures Ability to multi task and work under stressful situation Effective written and verbal communication skills 1+ year of customer service experience required Experience with medical office terminology preferred Work Schedule: 5 Days - 8 Hours Work Type: Full Time

Please read the information in this job post thoroughly to understand exactly what is expected of potential candidates. Performs a variety of complex administrative duties for patients in need of routine and/or urgent appointments, medical procedures, tests, and associated ancillary services in an ambulatory in/outpatient setting. Assess patients' needs, including but not limited to, financial counseling, interpreter services, social services and refers to appropriate person or area. Alerts providers to emergent patient care needs. Responsibilities: Receives and directs phone calls from patients and physician offices Schedules patients for treatment by multiple providers and treatment areas, and arranges a variety of associated tests and procedures according to established guidelines and specific criteria Prioritizes appointments in a manner that fosters optimum patient care, efficient utilization of physician's clinical staff, as well as equipment and facilities Handles urgent patient care calls and may alert providers to emergent patient care symptoms and concerns Schedules urgent care appointments as needed and directed by physician Greets patients for scheduled and/or urgent care appointments and procedures Confirms and verifies patient demographic and insurance information Collect co-payments from patients upon arrival when applicable Obtains signatures of consent from patient/guardian for treatment authorization and insurance/billing information Collaborates with insurers to obtain patients' prior authorizations for procedures and tests as needed Follows guidelines established by insurers to ensure that pre-authorization, pre-certification, and physician referrals for treatment are obtained prior to patient visits. xevrcyc Verifies eligibility for procedures or tests from various health care institutions Reviews and audits billing discrepancy reports and research errors for resolution Maintains accurate and timely records, logs, charges, files, and other related information as required Performs a variety of related administrative and clerical duties, such as retrieving files and other records, faxing, collating, data entry, and relaying messages to physicians, residents and staff Prepares special reports or spreadsheets for physicians as requested Complies with established departmental policies, procedures and objectives Complies with all health and safety regulations and requirements Contributes to maintaining a respectful environment of professionalism, tolerance, and acceptance toward all employees, patients and visitors Performs other duties as required. Requirements: Education/Skills High School Diploma or GED Proficient in software and computer systems Knowledgeable of business office terminology / procedures Ability to multi task and work under stressful situation Effective written and verbal communication skills Experience 1+ year of customer service experience required Experience with medical office terminology preferred Licenses, Registrations, or Certifications None Work Schedule: Varies Work Type: Full Time

Performs a variety of complex administrative duties for patients in need of routine and/or urgent appointments, medical procedures, tests, and associated ancillary services in an ambulatory in/outpatient setting. Assess patients' needs, including but not limited to, financial counseling, interpreter services, social services and refers to appropriate person or area. Alerts providers to emergent patient care needs. Responsibilities: Receives and directs phone calls from patients and physician offices Schedules patients for treatment by multiple providers and treatment areas, and arranges a variety of associated tests and procedures according to established guidelines and specific criteria Prioritizes appointments in a manner that fosters optimum patient care, efficient utilization of physician's clinical staff, as well as equipment and facilities Handles urgent patient care calls and may alert providers to emergent patient care symptoms and concerns Schedules urgent care appointments as needed and directed by physician Greets patients for scheduled and/or urgent care appointments and procedures Confirms and verifies patient demographic and insurance information Collect co-payments from patients upon arrival when applicable Obtains signatures of consent from patient/guardian for treatment authorization and insurance/billing information Collaborates with insurers to obtain patients' prior-authorizations for procedures and tests as needed Follows guidelines established by insurers to ensure that pre-authorization, pre-certification, and physician referrals for treatment are obtained prior to patient visits. Verifies eligibility for procedures or tests from various health care institutions Reviews and audits billing discrepancy reports and researches errors for resolution Maintains accurate and timely records, logs, charges, files, and other related information as required Performs a variety of related administrative and clerical duties, such as retrieving files and other records, faxing, collating, data entry, and relaying messages to physicians, residents and staff Prepares special reports or spreadsheets for physicians as requested Complies with established departmental policies, procedures and objectives Complies with all health and safety regulations and requirements Contributes in maintaining a respectful environment of professionalism, tolerance, and acceptance toward all employees, patients and visitors Performs other duties as required. Requirements: High School Diploma or GED Proficient in software and computer systems Knowledgeable of business office terminology / procedures Ability to multi task and work under stressful situation Effective written and verbal communication skills 1+ year of customer service experience required Experience with medical office terminology preferred Work Schedule: 5 Days - 8 Hours Work Type: Full Time

Applying for this role is straight forward Scroll down and click on Apply to be considered for this position. Performs a variety of complex administrative duties for patients in need of routine and/or urgent appointments, medical procedures, tests, and associated ancillary services in an ambulatory in/outpatient setting. Assess patients' needs, including but not limited to, financial counseling, interpreter services, social services and refers to appropriate person or area. Alerts providers to emergent patient care needs. CHRISTUS Santa Rosa Hospital - Westover Hills (CSRH-WH) is a 150-bed hospital serving the fastest growing area of San Antonio. Specialized care includes orthopedic and surgical services, ICU, women's services, a newborn nursery, comprehensive cardiovascular care from diagnostics to open heart surgery, vascular lab, sleep center, emergency services, the CHRISTUS Weight Loss Institute, wound care, rehabilitation, and more. The campus also boasts an Outpatient Imaging Center and three medical plazas, one of which houses our CHRISTUS Santa Rosa Family Medicine Residency Program and CHRISTUS Santa Rosa Family Health Center. Responsibilities: Receives and directs phone calls from patients and physician offices Schedules patients for treatment by multiple providers and treatment areas, and arranges a variety of associated tests and procedures according to established guidelines and specific criteria Prioritizes appointments in a manner that fosters optimum patient care, efficient utilization of physician's clinical staff, as well as equipment and facilities Handles urgent patient care calls and may alert providers to emergent patient care symptoms and concerns Schedules urgent care appointments as needed and directed by physician Greets patients for scheduled and/or urgent care appointments and procedures Confirms and verifies patient demographic and insurance information Collect co-payments from patients upon arrival when applicable Obtains signatures of consent from patient/guardian for treatment authorization and insurance/billing information Collaborates with insurers to obtain patients' prior-authorizations for procedures and tests as needed Follows guidelines established by insurers to ensure that pre-authorization, pre-certification, and physician referrals for treatment are obtained prior to patient visits. xevrcyc Verifies eligibility for procedures or tests from various health care institutions Reviews and audits billing discrepancy reports and research errors for resolution Maintains accurate and timely records, logs, charges, files, and other related information as required Performs a variety of related administrative and clerical duties, such as retrieving files and other records, faxing, collating, data entry, and relaying messages to physicians, residents and staff Prepares special reports or spreadsheets for physicians as requested Complies with established departmental policies, procedures and objectives Complies with all health and safety regulations and requirements Contributes in maintaining a respectful environment of professionalism, tolerance, and acceptance toward all employees, patients and visitors Performs other duties as required. Requirements: Education/Skills High School Diploma or GED Proficient in software and computer systems Knowledgeable of business office terminology / procedures Ability to multi task and work under stressful situation Effective written and verbal communication skills Experience 1+ year of customer service experience required Experience with medical office terminology preferred Licenses, Registrations, or Certifications None Work Schedule: 8AM - 5PM Monday-Friday Work Type: Full Time

Performs a variety of complex administrative duties for patients in need of routine and/or urgent appointments, medical procedures, tests, and associated ancillary services in an ambulatory in/outpatient setting. Assess patients' needs, including but not limited to, financial counseling, interpreter services, social services and refers to appropriate person or area. Alerts providers to emergent patient care needs. Responsibilities: Receives and directs phone calls from patients and physician offices Schedules patients for treatment by multiple providers and treatment areas, and arranges a variety of associated tests and procedures according to established guidelines and specific criteria Prioritizes appointments in a manner that fosters optimum patient care, efficient utilization of physician's clinical staff, as well as equipment and facilities Handles urgent patient care calls and may alert providers to emergent patient care symptoms and concerns Schedules urgent care appointments as needed and directed by physician Greets patients for scheduled and/or urgent care appointments and procedures Confirms and verifies patient demographic and insurance information Collect co-payments from patients upon arrival when applicable Obtains signatures of consent from patient/guardian for treatment authorization and insurance/billing information Collaborates with insurers to obtain patients' prior-authorizations for procedures and tests as needed Follows guidelines established by insurers to ensure that pre-authorization, pre-certification, and physician referrals for treatment are obtained prior to patient visits. Verifies eligibility for procedures or tests from various health care institutions Reviews and audits billing discrepancy reports and researches errors for resolution Maintains accurate and timely records, logs, charges, files, and other related information as required Performs a variety of related administrative and clerical duties, such as retrieving files and other records, faxing, collating, data entry, and relaying messages to physicians, residents and staff Prepares special reports or spreadsheets for physicians as requested Complies with established departmental policies, procedures and objectives Complies with all health and safety regulations and requirements Contributes in maintaining a respectful environment of professionalism, tolerance, and acceptance toward all employees, patients and visitors Performs other duties as required. Requirements: High School Diploma or GED Proficient in software and computer systems Knowledgeable of business office terminology / procedures Ability to multitask and work under stressful situation Effective written and verbal communication skills 1+ year of customer service experience required Experience with medical office terminology preferred Work Schedule: 8AM - 5PM Monday-Friday Work Type: Full Time

Performs a variety of complex administrative duties for patients in need of routine and/or urgent appointments, medical procedures, tests, and associated ancillary services in an ambulatory in/outpatient setting. Assess patients' needs, including but not limited to, financial counseling, interpreter services, social services and refers to appropriate person or area. Alerts providers to emergent patient care needs. CHRISTUS Santa Rosa Hospital - Westover Hills (CSRH-WH) is a 150-bed hospital serving the fastest growing area of San Antonio. Specialized care includes orthopedic and surgical services, ICU, women's services, a newborn nursery, comprehensive cardiovascular care from diagnostics to open heart surgery, vascular lab, sleep center, emergency services, the CHRISTUS Weight Loss Institute, wound care, rehabilitation, and more. The campus also boasts an Outpatient Imaging Center and three medical plazas, one of which houses our CHRISTUS Santa Rosa Family Medicine Residency Program and CHRISTUS Santa Rosa Family Health Center. Responsibilities: Receives and directs phone calls from patients and physician offices Schedules patients for treatment by multiple providers and treatment areas, and arranges a variety of associated tests and procedures according to established guidelines and specific criteria Prioritizes appointments in a manner that fosters optimum patient care, efficient utilization of physician's clinical staff, as well as equipment and facilities Handles urgent patient care calls and may alert providers to emergent patient care symptoms and concerns Schedules urgent care appointments as needed and directed by physician Greets patients for scheduled and/or urgent care appointments and procedures Confirms and verifies patient demographic and insurance information Collect co-payments from patients upon arrival when applicable Obtains signatures of consent from patient/guardian for treatment authorization and insurance/billing information Collaborates with insurers to obtain patients' prior-authorizations for procedures and tests as needed Follows guidelines established by insurers to ensure that pre-authorization, pre-certification, and physician referrals for treatment are obtained prior to patient visits. Verifies eligibility for procedures or tests from various health care institutions Reviews and audits billing discrepancy reports and research errors for resolution Maintains accurate and timely records, logs, charges, files, and other related information as required Performs a variety of related administrative and clerical duties, such as retrieving files and other records, faxing, collating, data entry, and relaying messages to physicians, residents and staff Prepares special reports or spreadsheets for physicians as requested Complies with established departmental policies, procedures and objectives Complies with all health and safety regulations and requirements Contributes in maintaining a respectful environment of professionalism, tolerance, and acceptance toward all employees, patients and visitors Performs other duties as required. Requirements: Education/Skills High School Diploma or GED Proficient in software and computer systems Knowledgeable of business office terminology / procedures Ability to multi task and work under stressful situation Effective written and verbal communication skills Experience 1+ year of customer service experience required Experience with medical office terminology preferred Licenses, Registrations, or Certifications None Work Schedule: 8AM - 5PM Monday-Friday Work Type: Full Time

CHRISTUS Santa Rosa Hospital - Westover Hills (CSRH-WH) is a 150-bed hospital serving the fastest growing area of San Antonio. Specialized care includes orthopedic and surgical services, ICU, women's services, a newborn nursery, comprehensive cardiovascular care from diagnostics to open heart surgery, vascular lab, sleep center, emergency services, the CHRISTUS Weight Loss Institute, wound care, rehabilitation, and more. The campus also boasts an Outpatient Imaging Center and three medical plazas, one of which houses our CHRISTUS Santa Rosa Family Medicine Residency Program and CHRISTUS Santa Rosa Family Health Center. Summary: Performs a variety of complex administrative duties for patients in need of routine and/or urgent appointments, medical procedures, tests, and associated ancillary services in an ambulatory in/outpatient setting. Assess patients' needs, including but not limited to, financial counseling, interpreter services, social services and refers to appropriate person or area. Alerts providers to emergent patient care needs. Responsibilities: Receives and directs phone calls from patients and physician offices Schedules patients for treatment by multiple providers and treatment areas, and arranges a variety of associated tests and procedures according to established guidelines and specific criteria Prioritizes appointments in a manner that fosters optimum patient care, efficient utilization of physician's clinical staff, as well as equipment and facilities Handles urgent patient care calls and may alert providers to emergent patient care symptoms and concerns Schedules urgent care appointments as needed and directed by physician Greets patients for scheduled and/or urgent care appointments and procedures Confirms and verifies patient demographic and insurance information Collect co-payments from patients upon arrival when applicable Obtains signatures of consent from patient/guardian for treatment authorization and insurance/billing information Collaborates with insurers to obtain patients' prior-authorizations for procedures and tests as needed Follows guidelines established by insurers to ensure that pre-authorization, pre-certification, and physician referrals for treatment are obtained prior to patient visits. Verifies eligibility for procedures or tests from various health care institutions Reviews and audits billing discrepancy reports and researches errors for resolution Maintains accurate and timely records, logs, charges, files, and other related information as required Performs a variety of related administrative and clerical duties, such as retrieving files and other records, faxing, collating, data entry, and relaying messages to physicians, residents and staff Prepares special reports or spreadsheets for physicians as requested Complies with established departmental policies, procedures and objectives Complies with all health and safety regulations and requirements Contributes in maintaining a respectful environment of professionalism, tolerance, and acceptance toward all employees, patients and visitors Performs other duties as required. Requirements: High School Diploma or GED Proficient in software and computer systems Knowledgeable of business office terminology / procedures Ability to multi task and work under stressful situation Effective written and verbal communication skills 1+ year of customer service experience required Experience with medical office terminology preferred Work Schedule: 5 Days - 8 Hours Work Type: Full Time

Department: CBO/PT Financial Services Shift: First Shift (United States of America) Standard Weekly Hours: 40 The Account Specialist II, Insurance Follow-Up & Denials Management is responsible for all insurance follow-up responsibilities for Cook Children's Physician Network. Primary duties are follow-up, analysis, and resolution of outstanding insurance claims; initiation of the appeals process on behalf of CCPN providers. The Account Specialist II, Insurance Follow-Up & Denials Management will primarily be responsible for performing duties such as; reimbursement analysis; provides the Manager, Insurance Follow-Up & Denials Management review, research, and resolution of claim denials with experience submitting appeals to various insurance companies while identifying payment trends in an effort to maximize collection; strong understanding of payer websites and appeal process by all payers including commercial and government payers including Tricare, Medicare, Medicaid, and Medicaid Managed care plans ; monitors active accounts receivable for identification of potential problems; strong research and analytical skills; must be a critical thinker ; communicates effectively with patients, practice managers, physicians and others regarding collection of outstanding claims; maintains proper documentation and edits of work performed; and at all times maintains a professional demeanor to assure that patients are treated in an appropriate and compassionate manner. Schedule: Mon-Fri, 7:30am-5:30pm Qualifications: High School or equivalent required Intermediate knowledge of coding and medical terminology with understanding of diversified health insurance plans a plus At least 3 years' experience in a physician billing environment or at least two (2) years in the capacity of PN Account Specialist I, with proficiency in performance of duties evidenced by a minimum rating of meets expectations on the most recent Performance Review 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. Medical terminology preferred Prior experience with Epic Resolute Professional Billing preferred About Cook Children's: Our not-for-profit organization is comprised of a flagship medical center in Fort Worth, Texas, a new medical center in Prosper, Texas, a physician network, home health company, surgery centers, health plan, health services, and health foundation. With more than 60 primary, specialty and urgent care locations throughout Texas, families can access our top-ranked specialty programs and network of services to meet the unique needs of their child. Cook Children's is honored to continually receive recognition for our outstanding efforts and outcomes in pediatric health care. At Cook Children's, we're more than a health care system-we're your friends, neighbors and even family members. And we're parents too, so we can see the world through your eyes. We see what you're going through-and how we can help you and your child get the best care and support possible. Cook Children's is an equal opportunity employer. As such, Cook Children's offers equal employment opportunities without regard to race, color, religion, sex, age, national origin, physical or mental disability, pregnancy, protected veteran status, genetic information, or any other protected class in accordance with applicable federal laws. These opportunities include terms, conditions and privileges of employment, including but not limited to hiring, job placement, training, compensation, discipline, advancement and termination.

Department: CBO/Patient Financial Services Shift: First Shift (United States of America) Standard Weekly Hours: 40 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.

Department: CBO/PT Financial Services Shift: First Shift (United States of America) Standard Weekly Hours: 40 The Account Specialist II, Insurance Follow-Up & Denials Management is responsible for all insurance follow-up responsibilities for Cook Children's Physician Network. Primary duties are follow-up, analysis, and resolution of outstanding insurance claims; initiation of the appeals process on behalf of CCPN providers. The Account Specialist II, Insurance Follow-Up & Denials Management will primarily be responsible for performing duties such as; reimbursement analysis; provides the Manager, Insurance Follow-Up & Denials Management review, research, and resolution of claim denials with experience submitting appeals to various insurance companies while identifying payment trends in an effort to maximize collection; strong understanding of payer websites and appeal process by all payers including commercial and government payers including Tricare, Medicare, Medicaid, and Medicaid Managed care plans ; monitors active accounts receivable for identification of potential problems; strong research and analytical skills; must be a critical thinker ; communicates effectively with patients, practice managers, physicians and others regarding collection of outstanding claims; maintains proper documentation and edits of work performed; and at all times maintains a professional demeanor to assure that patients are treated in an appropriate and compassionate manner. Schedule: Mon-Fri, 7:30am-5:30pm Qualifications: * High School or equivalent required * Intermediate knowledge of coding and medical terminology with understanding of diversified health insurance plans a plus * At least 3 years' experience in a physician billing environment or at least two (2) years in the capacity of PN Account Specialist I, with proficiency in performance of duties evidenced by a minimum rating of meets expectations on the most recent Performance Review * 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. Medical terminology preferred Prior experience with Epic Resolute Professional Billing preferred About Cook Children's: Our not-for-profit organization is comprised of a flagship medical center in Fort Worth, Texas, a new medical center in Prosper, Texas, a physician network, home health company, surgery centers, health plan, health services, and health foundation. With more than 60 primary, specialty and urgent care locations throughout Texas, families can access our top-ranked specialty programs and network of services to meet the unique needs of their child. Cook Children's is honored to continually receive recognition for our outstanding efforts and outcomes in pediatric health care. At Cook Children's, we're more than a health care system--we're your friends, neighbors and even family members. And we're parents too, so we can see the world through your eyes. We see what you're going through--and how we can help you and your child get the best care and support possible. Cook Children's is an equal opportunity employer. As such, Cook Children's offers equal employment opportunities without regard to race, color, religion, sex, age, national origin, physical or mental disability, pregnancy, protected veteran status, genetic information, or any other protected class in accordance with applicable federal laws. These opportunities include terms, conditions and privileges of employment, including but not limited to hiring, job placement, training, compensation, discipline, advancement and termination.

Provides medical collection services for TLRA collection units. Utilizes a strong background as a medical collection specialist to successfully resolve accounts placed with TLRA for collection. This involves performing collection activities related to follow-up and account resolution and includes communication with patients, clients, reimbursement vendors, and other external entities while adhering to all client, state, and federal guidelines. Patient and client satisfaction is essential. Associates in the collection units are expected to have knowledge of the overall collection work processes for both active AR and BD inventory. Responsibilities: * Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders. * Provides effective collection services, ensuring the successful recovery of accounts in accordance with client and state guidelines as well as TLRA's business objectives. * Documents and updates patient account information in TLRA's collection software system timely and accurate to include appropriate account status. * Handles inbound patient and/or carrier calls promptly and professionally, providing assistance and resolution to account inquiries, issues, and requests. * Uses collection tools effectively to ensure quality recovery services and meet or exceed established goals and work standards. * Performs research and analysis of account issues and strives to resolve problems timely and accurately. * Ensure daily productivity standards are met. * Promotes positive patient relations by communicating in a manner that demonstrates respect for the human dignity of patients and/or their families. * Must have solid knowledge and utilization of desktop applications to include Word and Excel are essential. * General hospital A/R accounts knowledge is required. * Performs other special projects as required when assigned. Collections - Insurance * Maintains active knowledge of all collection requirements by payors. * Collects balance owing from third-party payers in accordance with State and Federal laws governing collections practices. Ensures that collection efforts are thorough with the overall objective being to collect outstanding balances in an ethical manner. * Ensures quality standards are met and proper documentation regarding patient accounting records. * Contact other departments to obtain necessary information for appeals, pending information, and any other issues that impact and/or delay claim processing. Collections - Self Pay * Ensures that self-pay accounts are handled in a customer service-oriented manner that accomplishes the goal of collecting monies due to clients, while at the same time preserving the positive image of TLRA that exists in the community. * Responsible for assisting patients in identifying eligible means of financial assistance or if non apply working with the patient to make acceptable payment arrangements. * Must be an effective team member with good communication skills. Must participate in team meetings, communicate work-related ideas and concerns proactively, and assist in finding appropriate resolutions. Physician Billing/Collections * Ensure proper reimbursement for all services and to ensure all appeals are filed timely. * Review accounts and determine appropriate follow-up activities utilizing Six Sigma Practices. * Identify under and overpayments and take appropriate actions to resolve accounts. * Validate commercial insurance claims to ensure the claims are paid according to the contract. * Direct knowledge using Meditech and CollectLogix software. * Monitor and communicate errors generated by other groups and evaluate for trends. Job Requirements: Education/Skills * High School diploma or equivalent years of experience required. Experience * 3-5 years of experience preferred. * experience in a Customer Service call center environment with a focus on healthcare billing/collections or collection agency environment required. * College education, previous Insurance Company claims experience and/or health care billing trade school education may be considered in lieu of formal hospital experience. Licenses, Registrations, or Certifications * None required. Work Schedule: 5 Days - 8 Hours Work Type: Full Time

Provides medical collection services for TLRA collection units. Utilizes a strong background as a medical collection specialist to successfully resolve accounts placed with TLRA for collection. This involves performing collection activities related to follow-up and account resolution and includes communication with patients, clients, reimbursement vendors, and other external entities while adhering to all client, state, and federal guidelines. Patient and client satisfaction is essential. Associates in the collection units are expected to have knowledge of the overall collection work processes for both active AR and BD inventory. Responsibilities: * Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders. * Provides effective collection services, ensuring the successful recovery of accounts in accordance with client and state guidelines as well as TLRA's business objectives. * Documents and updates patient account information in TLRA's collection software system timely and accurate to include appropriate account status. * Handles inbound patient and/or carrier calls promptly and professionally, providing assistance and resolution to account inquiries, issues, and requests. * Uses collection tools effectively to ensure quality recovery services and meet or exceed established goals and work standards. * Performs research and analysis of account issues and strives to resolve problems timely and accurately. * Ensure daily productivity standards are met. * Promotes positive patient relations by communicating in a manner that demonstrates respect for the human dignity of patients and/or their families. * Must have solid knowledge and utilization of desktop applications to include Word and Excel are essential. * General hospital A/R accounts knowledge is required. * Performs other special projects as required when assigned. Collections - Insurance * Maintains active knowledge of all collection requirements by payors. * Collects balance owing from third-party payers in accordance with State and Federal laws governing collections practices. Ensures that collection efforts are thorough with the overall objective being to collect outstanding balances in an ethical manner. * Ensures quality standards are met and proper documentation regarding patient accounting records. * Contact other departments to obtain necessary information for appeals, pending information, and any other issues that impact and/or delay claim processing. Collections - Self Pay * Ensures that self-pay accounts are handled in a customer service-oriented manner that accomplishes the goal of collecting monies due to clients, while at the same time preserving the positive image of TLRA that exists in the community. * Responsible for assisting patients in identifying eligible means of financial assistance or if non apply working with the patient to make acceptable payment arrangements. * Must be an effective team member with good communication skills. Must participate in team meetings, communicate work-related ideas and concerns proactively, and assist in finding appropriate resolutions. Physician Billing/Collections * Ensure proper reimbursement for all services and to ensure all appeals are filed timely. * Review accounts and determine appropriate follow-up activities utilizing Six Sigma Practices. * Identify under and overpayments and take appropriate actions to resolve accounts. * Validate commercial insurance claims to ensure the claims are paid according to the contract. * Direct knowledge using Meditech and CollectLogix software. * Monitor and communicate errors generated by other groups and evaluate for trends. Job Requirements: Education/Skills * High School diploma or equivalent years of experience required. Experience * 3-5 years of experience preferred. * experience in a Customer Service call center environment with a focus on healthcare billing/collections or collection agency environment required. * College education, previous Insurance Company claims experience and/or health care billing trade school education may be considered in lieu of formal hospital experience. Licenses, Registrations, or Certifications * None required. Work Schedule: 8AM - 5PM Monday-Friday Work Type: Full Time

Performs a variety of complex administrative duties for patients in need of routine and/or urgent appointments, medical procedures, tests, and associated ancillary services in an ambulatory in/outpatient setting. Assess patients' needs, including but not limited to, financial counseling, interpreter services, social services and refers to appropriate person or area. Alerts providers to emergent patient care needs. Responsibilities: Receives and directs phone calls from patients and physician offices Schedules patients for treatment by multiple providers and treatment areas, and arranges a variety of associated tests and procedures according to established guidelines and specific criteria Prioritizes appointments in a manner that fosters optimum patient care, efficient utilization of physician's clinical staff, as well as equipment and facilities Handles urgent patient care calls and may alert providers to emergent patient care symptoms and concerns Schedules urgent care appointments as needed and directed by physician Greets patients for scheduled and/or urgent care appointments and procedures Confirms and verifies patient demographic and insurance information Collect co-payments from patients upon arrival when applicable Obtains signatures of consent from patient/guardian for treatment authorization and insurance/billing information Collaborates with insurers to obtain patients' prior-authorizations for procedures and tests as needed Follows guidelines established by insurers to ensure that pre-authorization, pre-certification, and physician referrals for treatment are obtained prior to patient visits. Verifies eligibility for procedures or tests from various health care institutions Reviews and audits billing discrepancy reports and researches errors for resolution Maintains accurate and timely records, logs, charges, files, and other related information as required Performs a variety of related administrative and clerical duties, such as retrieving files and other records, faxing, collating, data entry, and relaying messages to physicians, residents and staff Prepares special reports or spreadsheets for physicians as requested Complies with established departmental policies, procedures and objectives Complies with all health and safety regulations and requirements Contributes in maintaining a respectful environment of professionalism, tolerance, and acceptance toward all employees, patients and visitors Performs other duties as required. Requirements: High School Diploma or GED required Proficient in software and computer systems Knowledgeable of business office terminology / procedures Ability to multi task and work under stressful situation Effective written and verbal communication skills 1+ year of customer service experience required Experience with medical office terminology preferred Work Schedule: 8AM - 5PM Monday-Friday Work Type: Full Time

Employees in this position are responsible for the maintenance of patient billing accounts and performing numerous related functions to accomplish this task; such as, patient registration, insurance follow-up, financial screening of unfunded patients, answering patient billing inquiries, collection of unpaid balances and posting of payments in the Regional Campus Business Office. Maintains confidentiality in accordance with HIPAA standards and complies with all federal, state, and institutional guidelines. Post Insurance payments and rejections. Post all patient payments received through the Patient Pay Lockbox, IVR, and Text-to-Pay systems. Collect daily deposits from clinical staff to be reconciled the following day. Additionally, process deposit bags dropped off by Rochester and ensure all deposits are accurately logged in Excel and the Cash Receipts (CR) system. Use fundamental computer skills with Excel, Outlook, fax machine, typing (35 wpm) and 10-key by touch. A minimum of a high school diploma or equivalent. Two years of medical or general office experience OR Completion of related education or training and one year of experience.

Employees in this position are responsible for the maintenance of patient billing accounts and performing numerous related functions to accomplish this task; such as, patient registration, insurance follow-up, financial screening of unfunded patients, answering patient billing inquiries, collection of unpaid balances and posting of payments in the Regional Campus Business Office. Maintains confidentiality in accordance with HIPAA standards and complies with all federal, state, and institutional guidelines. Assist patients with account inquiries, corrections, budget plans, and statements. Verify and update patient information; report changes to management. Process deceased accounts, bankruptcies, legal requests, and attorney inquiries. Post payments, run credit card transactions, and reconcile settlements. Review collection agency payments and Charity Care applications for accuracy. Respond to clinic and patient questions regarding Charity Care processes. Maintain and balance the business office cash box. Prepare and route billing records for legal documentation and notarization. Deliver quality customer service and prompt responses to patient needs. Collaborate with team members, sharing knowledge and solving problems. Provide leadership and guidance to billing associates and staff. Comply with TTUHSC operating policies and maintain a strong work ethic. Bilingual communication skills English/Spanish Medical office or healthcare billing experience Experience using with Microsoft Office applications, including Outlook, Excel, and Word Experience with Cerner electronic medical record system Ability to use Zoom for virtual meetings and communication Pay Statement Compensation is commensurate upon the qualifications of the individual selected and budgetary guidelines of the hiring department, as well as the institutional pay plan. For additional information, please reference the institutional pay plan website at ******************************** EEO Statement All qualified applicants will be considered for employment without regard to sex, race, color, national origin, religion, age, disability, protected veteran status, or genetic information. Required Qualifications A minimum of a high school diploma or equivalent. Two years of medical or general office experience OR Completion of related education or training and one year of experience. Jeanne Clery Act The Jeanne Clery Disclosure of Campus Security Policy and Campus Crime Statistics Act is a federal statute requiring colleges and universities participating in federal financial aid programs to maintain and disclose campus crime statistics and security information. By October 1 of each year, institutions must publish and distribute their Annual Campus Security Policy & Crime Statistics Report (ASR) to current and prospective students and employees. To view this report, visit the TTUHSC Clery Act website at **************************************************** Introduction Nationally recognized as a Great College to Work For , TTUHSC provides much more than just a job! Enjoy excellent benefits, including paid leave, retirement plans, wellness programs, health insurance and so much more. Ready to start building a rewarding career in a positive environment where you can develop and thrive? Join us as we change the future of health care. About TTUHSC Texas Tech University Health Sciences Center is enriching the lives of others by educating students, providing excellent patient care, and advancing knowledge through innovative research. TTUHSC graduates more health care professionals than any other health care institution in the state, conferring 24.2% of all degrees and certificates awarded from health-related institutions in Texas. By providing comprehensive clinical services to more than 10 million individuals across 121 counties, TTUHSC is dedicated to advancing the health of people throughout Texas and beyond. This is where world-class education meets compassionate patient care - and we believe that our people are the reason for our institution's lasting success and bright future. Being part of the TTUHSC team means being part of an innovative and supportive community that empowers each individual to do their best work. Through our values-based culture, TTUHSC is committed to cultivating an exceptional workplace community with a positive culture that puts people first. Benefits TTUHSC is committed to creating an environment where our team members can do their best work, with programs and benefits to support head-to-toe well-being. Explore just a few of the advantages of being a TTUHSC team member: Health Plans + Supplemental Coverage Options - Individual health insurance provided at no cost for full-time team members Paid Time Off - Including holidays, vacation, sick leave and more Retirement Plans Wellness Programs Certified Mother-Friendly Workplace Additionally, TTUHSC invests in the success of our team members by providing opportunities for personal and professional growth, including lifelong learning programs, recognition programs, and health and wellness initiatives. Team members also enjoy a variety of other perks, such as special membership rates at local gyms and golf courses, access to state-of-the-art software and facilities, and discounts on travel, technology, entertainment and more.

Performs a variety of complex administrative duties for patients in need of routine and/or urgent appointments, medical procedures, tests, and associated ancillary services in an ambulatory in/outpatient setting. Assess patients' needs, including but not limited to, financial counseling, interpreter services, social services and refers to appropriate person or area. Alerts providers to emergent patient care needs. Responsibilities: Receives and directs phone calls from patients and physician offices Schedules patients for treatment by multiple providers and treatment areas, and arranges a variety of associated tests and procedures according to established guidelines and specific criteria Prioritizes appointments in a manner that fosters optimum patient care, efficient utilization of physician's clinical staff, as well as equipment and facilities Handles urgent patient care calls and may alert providers to emergent patient care symptoms and concerns Schedules urgent care appointments as needed and directed by physician Greets patients for scheduled and/or urgent care appointments and procedures Confirms and verifies patient demographic and insurance information Collect co-payments from patients upon arrival when applicable Obtains signatures of consent from patient/guardian for treatment authorization and insurance/billing information Collaborates with insurers to obtain patients' prior-authorizations for procedures and tests as needed Follows guidelines established by insurers to ensure that pre-authorization, pre-certification, and physician referrals for treatment are obtained prior to patient visits. Verifies eligibility for procedures or tests from various health care institutions Reviews and audits billing discrepancy reports and researches errors for resolution Maintains accurate and timely records, logs, charges, files, and other related information as required Performs a variety of related administrative and clerical duties, such as retrieving files and other records, faxing, collating, data entry, and relaying messages to physicians, residents and staff Prepares special reports or spreadsheets for physicians as requested Complies with established departmental policies, procedures and objectives Complies with all health and safety regulations and requirements Contributes in maintaining a respectful environment of professionalism, tolerance, and acceptance toward all employees, patients and visitors Performs other duties as required. Requirements: High School Diploma or GED required Proficient in software and computer systems Knowledgeable of business office terminology / procedures Ability to multi task and work under stressful situation Effective written and verbal communication skills 1+ year of customer service experience required Experience with medical office terminology preferred Work Schedule: 8AM - 5PM Monday-Friday Work Type: Full Time

Employees in this position are responsible for the maintenance of patient billing accounts and performing numerous related functions to accomplish this task; such as, patient registration, insurance follow-up, financial screening of unfunded patients, answering patient billing inquiries, collection of unpaid balances and posting of payments in the Regional Campus Business Office. Maintains confidentiality in accordance with HIPAA standards and complies with all federal, state, and institutional guidelines. Posting manual payments and electronic remits into the Practice Management System. Complete posting corrections and move unassigned payments. Update spreadsheets. Willing to help other team members with posting assignments as needed. A minimum of a high school diploma or equivalent. Two years of medical or general office experience OR Completion of related education or training and one year of experience.