Mgr, Ins Follow Up&Denials Gov

About this role

Location: Calmont Operations Building Department: CBO/Patient Financial Services Shift: First Shift (United States of America) Standard Weekly Hours: 40 Summary: Under the direction of the Director of Revenue Cycle, the Insurance Follow-Up & Denials Manager is responsible for managing hospital accounts receivable for Government (Medicaid, Medicare and Government Managed Care) payors through claim follow up, cash collection, and denial prevention. The Manager is to organize and coordinate the reimbursement and accounting of patient accounts in accordance with departmental and organization objectives, policies and procedures. This position operates independently and directly supervises all follow-up/collection staff. The Insurance Follow-Up & Denials Manager requires complex data analysis and makes independent decisions within the scope of responsibility. Major decisions are subject to approval of the Director. Internal contacts consist of all levels of staff and management throughout Cook Children’s Health Care System (CCHCS). External contacts consist of patients and their families, insurance companies, physicians and their staff, state and federal agencies, auditors, and vendors. Contacts are for the purpose of resolving issues and discussing sensitive and confidential information with all contact levels.

Qualifications: • High School Diploma or equivalent required.

• Bachelor’s degree in business, Accounting, Finance or related field preferred

• Minimum five years’ experience in hospital accounts receivable experience

• Three plus years of progressive supervisory / management experience

Knowledge / Skills / Abilities: • Apply appropriate management and leadership techniques in an operational setting

• Work independently and take initiative

• Ability to deal effectively with constant changes and be a change agent

• Interact and communicate both verbally and in writing with all levels of associates, management and customers in Healthcare / Business

• Extensive knowledge of state, federal and compliance regulations as they pertain to insurance claim processing and third-party reimbursement

• Detailed knowledge of diversified insurance plans including Medicare, Medicaid and commercial payors, and claim processing and reimbursement methodologies

• Prior experience with Epic Systems Revenue Cycle Solutions 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.

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