Remote Medical Reimbursement Specialist

NemoursCareerSite; Jacksonville (FL); Remote; USD 42,000 - 64,000; Full time

Job summary

Nemours is seeking a Medical Reimbursement Specialist in Jacksonville, FL. The role focuses on resolving open insurance balances through collections and researching unpaid, underpaid, and denied claims to ensure timely resolution. This is a remote position with residency requirements in several states.

Applicants must reside in the listed states, including Florida. The essential duties include reviewing coding and contract terms, reporting denial trends, and accurately entering data into Epic

Qualifications

• High School Diploma required.
• 1–3 years of relevant healthcare billing experience.
• Experience with insurance claims, denials and adjustments.

Responsibilities

• Facilitate resolution of open receivables by review of coding, billing, contract terms, and authorizations.
• Diagnose and report issues with rejection and denial trends to management.
• Maintain accurate documentation of claim follow up activities.
• Address inquiries on adjustments, account changes, guarantor merges, and transfers per guidelines.
• Address insurance denials and underpayments, appealing / adjusting balances accordingly.
• Enter patient demographics, guarantor and coverage information into Epic.
• Change filing order, list necessary adjustments, distribute payments to service dates.

Skills

Medical collections

Insurance billing

Denial management

Customer service

Receivables follow-up

Education

High School Diploma

Tools

Epic

Billing systems

Job description

Nemours is seeking a Medical Reimbursement Specialist in Jacksonville, FL. The role focuses on resolving open insurance balances through collections and researching unpaid, underpaid, and denied claims to ensure timely resolution. This is a remote position with residency requirements in several states.

Applicants must reside in the listed states, including Florida. The essential duties include reviewing coding and contract terms, reporting denial trends, and accurately entering data into Epic