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Description At CrescentCare, we bring caregivers and the community together as partners in health and wellness for all. Our experience builds on more than 40 years of impact. In 2014, we became a Federally Qualified Health Center to offer an expanded range of health and wellness services for anyone and everyone who is seeking healthcare services in Greater New Orleans and Southeastern Louisiana.   Our Mission Strengthening our entire community through whole-person healthcare and education.   Position Summary This position is responsible for managing all aspects of the revenue cycle functions for CrescentCare a Federally Qualified Health Center.  These functions include, but are not limited to, claims submissions, managing denials and rejections, coding services, payment recording, credentialing services and collections.  This position is responsible for ensuring compliance with insurance billing and coding standards (Medicare, Medicaid,...

Candidates must be able to work on-site. This position is not remote. GENERAL PURPOSE OF JOB: The Claims and Appeals Specialist II is a certified medical coder that performs audits for correct coding and claims payments and oversees the claims appeal process for provider and member appeals. This position also investigates Coordination of Benefit (COB) claims. The Claims and Appeals Specialist II reports to the Director of Claims Oversight. ESSENTIAL DUTIES AND RESPONSIBILITIES: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. This job description is not intended to be all-inclusive; employees will perform other reasonably related business duties as assigned by the immediate...

Position Overview We are seeking an experienced Billing Specialist to join our busy infertility practice. The ideal candidate is preferred to have billing experience in women's health care. This role requires strong knowledge of medical billing workflows, insurance follow-up, denial management, payment posting, claims resolution, and patient account management specific to women’s health. Key Responsibilities   Submit clean claims accurately and timely through our EMR system  Review and resolve claim rejections and denials across all insurance platforms  Follow up with insurance companies on unpaid claims  Post insurance and patient payments accurately in our EMR system  Work aging reports and outstanding AR  Review patient accounts for billing accuracy and follow-up needs  Handle billing corrections, resubmissions, and appeals  Communicate with registration/front desk, clinical staff, and management to resolve   billing issues  Maintain compliance with...

Account Specialist II Locations: Fort Worth, TX Time type: Full time Job requisition id: JR-114239 Location: Calmont Operations Building Department: CBO/Patient Financial Services Shift: First Shift (United States of America) Standard Weekly Hours: 40 Summary: 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...