About the role

  • Senior Medical Reimbursement Analyst handling high dollar insurance claims resolution in pediatric healthcare. Researching unpaid claims and ensuring timely resolution to meet collection goals.

Responsibilities

  • Work accounts until all charges are paid or denied by the insurance carrier.
  • Understand and apply principles of reimbursement to all aspects of the revenue cycle.
  • Account for high dollar balances and keep abreast of insurance trends.
  • Pursue payment from payors related to both denials and underpayment.
  • Accurately enter patient demographics and coverage information into Epic system.
  • Apply problem solving skills to resolve discrepancies.
  • Work jointly with all departments along the revenue cycle to resolve issues.
  • Keep abreast of all insurance and system changes.
  • Apply balance adjustments as appropriate and accurately bill the guarantor.

Requirements

  • High School Diploma
  • 1-3 years of experience

Benefits

  • Nemours Children's Health is an internationally recognized pediatric health system serving more than 1.7 million patient encounters each year.
  • Delivery of care across six states through two freestanding children’s hospitals along with a network of more than 80 primary, urgent, and specialty care practices and more than 40 hospital partnerships.
  • Backed by the Nemours Foundation and Alfred I. duPont Trust, our $1.7B nonprofit system is dedicated to improving children's health through clinical care, research, education, advocacy, and prevention.
  • Our Whole Child Health approach focuses equally on prevention and treatment, partnering with communities to help every child thrive.
  • Inclusion and belonging guide our strategy and growth.

Job title

Senior Medical Reimbursement Analyst

Job type

Experience level

Senior

Salary

Not specified

Degree requirement

High School Diploma

Location requirements

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