Medical Reimbursement Specialist: Denials & Collections

Nemours in; Jacksonville (FL); On-site; USD 40,000 - 56,000; Full time

Job summary

Nemours Children's Health in Jacksonville, FL seeks a Medical Reimbursement Specialist to resolve open insurance balances by researching unpaid, underpaid, and denied claims. You will apply contractual billing guidelines and ensure timely resolution while maintaining thorough documentation and high-quality customer service.

The role emphasizes addressing denials, underpayments, and guarantor billing while accurately entering demographics in Epic and adhering to enterprise guidelines to support

Qualifications

• High school diploma required.
• 1–3 years of experience in medical billing or reimbursement.

Responsibilities

• Resolve open insurance balances by researching unpaid, underpaid, and denied claims.
• Apply contractual billing and payment guidelines to achieve timely resolution.
• Document claim follow-up activities accurately.
• Address inquiries for adjustments, changes, and transfers per guidelines.
• Enter patient demographics and coverage in the Epic system.
• Identify denial trends and report issues to management.

Skills

Customer service

Problem solving

Communication

Attention to detail

Education

High School Diploma

Tools

Epic

Job description

Nemours Children's Health in Jacksonville, FL seeks a Medical Reimbursement Specialist to resolve open insurance balances by researching unpaid, underpaid, and denied claims. You will apply contractual billing guidelines and ensure timely resolution while maintaining thorough documentation and high-quality customer service.

The role emphasizes addressing denials, underpayments, and guarantor billing while accurately entering demographics in Epic and adhering to enterprise guidelines to support