Remote Medical Reimbursement Specialist Denials

Nemours-Children; Jacksonville (FL); Remote; USD 45,000 - 65,000; Full time

Job summary

Nemours is seeking a Medical Reimbursement Specialist for a remote position based in Jacksonville, FL. You will resolve open insurance balances by researching unpaid, underpaid, and denied claims, applying contractual billing guidelines to ensure timely resolutions and meet collection goals.

The role requires 1–3 years of relevant experience and a High School Diploma, with responsibilities including denial management, accurate documentation in Epic, and collaboration with management to improve

Qualifications

• 1–3 years of relevant experience in medical billing or reimbursement.

Responsibilities

• Resolve open receivables by reviewing coding, billing, and contract terms.
• Investigate denials and underpayments; communicate with management on denial trends.
• Maintain accurate documentation of claim follow-up activities.
• Handle customer inquiries for adjustments, account changes, and transfers according to guidelines.
• Address insurance denials and underpayments; adjust balances as needed.
• Enter patient demographics, guarantor and coverage data into Epic system.
• Apply correct filing order; distribute payments to service dates; request changes when needed.
• Stay informed on insurance and system changes; provide excellent service aligned with Nemours' mission.

Education

High School Diploma

Tools

Epic

Job description

Nemours is seeking a Medical Reimbursement Specialist for a remote position based in Jacksonville, FL. You will resolve open insurance balances by researching unpaid, underpaid, and denied claims, applying contractual billing guidelines to ensure timely resolutions and meet collection goals.

The role requires 1–3 years of relevant experience and a High School Diploma, with responsibilities including denial management, accurate documentation in Epic, and collaboration with management to improve