Senior Medical Reimbursement Analyst

Nemours in; Jacksonville (FL); On-site; USD 65,000 - 90,000; Full time

Job summary

Nemours seeks a Senior Medical Reimbursement Analyst to resolve high-dollar insurance balances by researching unpaid, underpaid, and denied claims. You will apply contractual billing guidelines and coordinate with internal departments to improve resolution times.

Key duties include entering demographics in Epic, performing retro adjudication, and pursuing payor payments across communications channels. Collaboration with the revenue cycle is essential to drive accuracy and efficiency.

Qualifications

• Proficient understanding of revenue cycle and insurance reimbursement processes.
• Ability to analyze and resolve high-dollar insurance balances.
• Experience with patient demographics and claim adjustments.

Responsibilities

• Resolve open high-dollar insurance balances through collections and denial management.
• Apply reimbursement guidelines across billing, coding, and recovery processes.
• Enter demographics and coverage in Epic; perform retro adjudication and adjustments as needed.
• Communicate with payors to pursue payment on denials or underpayments.
• Collaborate with revenue cycle departments to resolve issues and improve collections.

Education

High school diploma

Tools

Epic system

Job description

Nemours seeks a Senior Medical Reimbursement Analyst to resolve high-dollar insurance balances by researching unpaid, underpaid, and denied claims. You will apply contractual billing guidelines and coordinate with internal departments to improve resolution times.

Key duties include entering demographics in Epic, performing retro adjudication, and pursuing payor payments across communications channels. Collaboration with the revenue cycle is essential to drive accuracy and efficiency.