PN Mgr Ins Follow up & Denials Job

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.

Education & Experience

• 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.

Cook Children's is an EOE/AA - Minority/Females/Disability/Vet