reimbursement manager

Inizio Engage

<p></p><div><div><div><p><b>Virtual Access and Reimbursement Manager</b></p></div><p></p><div><p>
Inizio Engage has a long-standing partnership with a leading Biotechnology company, across Commercial, Patient Solutions and Medical Affairs businesses.</p></div><p></p><div><p>
The Virtual Access and Reimbursement Manager will provide education to HCPs staff of enrolled patients in HUB or specialty pharmacy network who have been prescribed our client&rsquo;s product. They will engage healthcare providers, and their staff to communicate and educate on patient benefit coverage, prior authorization processes, general payer policy criteria and affordability programs supporting the initiation of the products. They will have a solid understanding of the local, regional and national payer landscape. They will have understand of multiple data sets and actions will be influenced b the status of the patient in the journey to Rx fulfillment. There may be a possibility for the Individual to conduct an in-person HCP office interactions with staff, as determined by business needs.</p></div><p></p><div><p>
This is your opportunity to join Inizio Engage and represent a top biotechnology company!</p></div><p></p><div><p><b>
What&rsquo;s</b><b> </b><b>in it for you?</b></p></div><div><ul><li><p>
Competitive compensation</p></li></ul></div><div><ul><li><p>
Excellent Benefits &ndash; accrued time off, medical, dental, vision, 401k, disability &amp; life insurance, paid maternity and bonding time benefits, employee discounts/promotions</p></li></ul></div><div><ul><li><p>
Generous performance-driven Incentive Compensation package</p></li></ul></div><div><ul><li><p>
Competitive environment with company wide recognition, contests, and coveted awards</p></li></ul></div><div><ul><li><p>
Exceptional company culture</p></li></ul></div><div><ul><li><p>
Recognized as a Top Workplace USA 2021</p></li></ul></div><div><ul><li><p>
Awarded a &ldquo;Great Place to Work&rdquo; award in 2022, 2023 &amp; 2024</p></li></ul></div><div><ul><li><p>
Fortune Best Workplaces in Biopharma 202, 2023 &amp; 2024
</p></li></ul></div><p></p><div><p><b>What will you be doing?</b></p></div><div><ul><li><p>
Engage healthcare providers and appropriate office staff to educate on access to prescribed treatments within the specialty pharmacy and HUB channel, including addressing questions about initial access, insurance approval and reauthorizations pertaining to the initiation of product.</p></li></ul></div><div><ul><li><p>
Educate HCP office staff about prior authorization &amp; appeals process, how to access related forms, and high-level information about submission procedures and reauthorization requirements.</p></li></ul></div><div><ul><li><p>
Work compliantly and proactively to identify and resolve patient access and reimbursement issues, within assigned geography. Assigned geography may be adjusted based on zone and national volume.</p></li></ul></div><div><ul><li><p>
Provide appropriate factual process information to HCP office utilizing Personal Health Information (PHI), with appropriate patient consent.</p></li></ul></div><div><ul><li><p>
Serve as reimbursement expert for patient support services team for assigned geography/plans.</p></li></ul></div></div><div><div><ul><li><p>
Utilize approved resources and call guides/FAQs to provide education and answer questions as needed.</p></li></ul></div><div><ul><li><p>
Conduct ongoing payer policy reviews and contribute local, regional and national policy insights to Field Access Managers and client leadership.</p></li></ul></div><div><ul><li><p>
Virtually manage assigned accounts and align with Field Access and Reimbursement team, sales teams as well as specialty pharmacy and HUB team on ongoing support needs.</p></li></ul></div><div><ul><li><p>
Document call details with attention to data integrity to ensure compliance with program policies and business rules.</p></li></ul></div><div><ul><li><p>
Navigate CRM platform in daily interactions and learn internal team processes (when available).</p></li></ul></div><div><ul><li><p>
Maintain confidentiality of Patient Health Information (PHI) and act in compliance with all laws, regulations, and company policies.</p></li></ul></div><div><ul><li><p>
Triage appropriate escalations to the Field Access Manager team in accordance with the program design and business rules.</p></li></ul></div><div><ul><li><p>
Comply, take, and attend all required training.</p></li></ul></div><div><ul><li><p>
Adhere to all Inizio and client policies, procedures, business rules, and call guides, as well as applicable laws.</p></li></ul></div><p></p><div><p><b><br>
Requirements</b></p></div><div><ul><li><p>
BS/BA Degree Required</p></li></ul></div><div><ul><li><p>
Proven success operating in a virtual environment</p></li></ul></div><div><ul><li><p>
3+ years of relevant experience in &ndash; reimbursement and patient access, market access, specialty pharmacy, or physician/system account management.</p></li></ul></div><div><ul><li><p>
Experience engaging HCP staff in a support role to educate on access pathways and product requirements.</p></li></ul></div><div><ul><li><p>
Experience navigating payer reimbursement process for oral medications.</p></li></ul></div><div><ul><li><p>
Experience with specialty products acquired through specialty pharmacy networks.</p></li></ul></div><div><ul><li><p>
Patient-centric and service-oriented mindset, with a high degree of emotional intelligence and empathy.</p></li></ul></div><div><ul><li><p>
Exceptional customer and patient engagement skills, attention to detail, and the ability to think comprehensively is a must.</p></li></ul></div><div><ul><li><p>
Exemplary interpersonal and listening skills.</p></li></ul></div><div><ul><li><p>
Strong communication (written and verbal), and presentation skills.</p></li></ul></div></div><div><div><ul><li><p>
High enthusiasm with a drive to success within a team &ndash; demonstrated ability to reach common goals in collaboration with multiple therapeutic specialists, sales leadership, market access, and patient support services colleagues.</p></li></ul></div><div><ul><li><p>
Highly organized with excellent attention to detail and the ability to multi-task in engaging both patients and providers.</p></li></ul></div><div><p><br>
</p></div><div><p><b>About</b><b> </b><b>Inizio</b><b> </b><b>Engage</b><br>
Inizio Engage is a strategic, commercial, and creative engagement partner that specializes in healthcare. Our passionate, global workforce augments local expertise and diverse mix of skills with data, science, and technology to deliver bespoke engagement solutions that help clients reimagine how they engage with their patients, payers, people and providers to improve treatment outcomes. Our mission is to partner with our clients, improving lives by helping healthcare professionals and patients get the medicines, knowledge and support they need.
</p></div><div><p>We believe in our values: <b>We empower everyone/We rise to the challenge/We work as one/We ask what if/We do the right thing</b>, and we will ask you how your personal values align to them.</p></div><p></p><div><p>
To learn more about Inizio Engage, visit us at: https://inizio.health/</p></div><div><p>
Inizio Engage is proud to be an equal opportunity employer. Individuals seeking employment at Inizio are considered without regards to age, ancestry, color, gender, gender identity or expression, genetic information, marital status, medical condition (including pregnancy, childbirth, or related medical conditions), mental or physical disability, national origin, protected family care or medical leave status, race, religion (including beliefs and practices or the absence thereof), sexual orientation, military or veteran status, or any other characteristic protected by federal, state, or local laws. Further, pursuant to applicable local ordinances, Inizio will consider for employment qualified applicants with arrest and conviction records.</p></div><p></p><div><p>
Inizio Engage is an equal opportunity employer M/F/V/D. We appreciate your interest in our company, however, only qualified candidates will be considered.</p></div></div></div>

Hybrid Access & Reimbursement Manager

AbbVie

<div><b>Company Description</b><p><b><br>
About AbbVie</b></p><p>
AbbVie's mission is to discover and deliver innovative medicines and solutions that solve serious health issues today and address the medical challenges of tomorrow. We strive to have a remarkable impact on people's lives across several key therapeutic areas including immunology, oncology and neuroscience - and products and services in our Allergan Aesthetics portfolio. For more information about AbbVie, please visit us at www.abbvie.com. Follow @abbvie on LinkedIn, Facebook, Instagram, X and YouTube.</p><b><br>
Job Description</b><p><br>
The Field Reimbursement Manager (FRM) shares expertise and educates on Medical and Pharmacy benefits, Buy &amp; Bill and Specialty Pharmacy acquisition, payor policy, appropriate patient identification, clinical documentation, benefit investigation results, prior authorizations, billing, coding, patient tracking, claim submission, reconciliation management, patient financial savings programs, patient tracking/retreatment, and the denial/appeal process for the approved indications for BOTOX&reg; Therapeutics. The FRM clarifies barriers that may impede or delay appropriate patient access to treatment and/or prevent optimal patient outcomes. The FRM may interact with healthcare providers, administrative staff, revenue cycle management, and institutional leadership.</p><br>
<p></p><ul><li>
Educate on the fundamentals of the BOTOX treatment process, appropriate reimbursement, and understanding the payer landscape</li><li>
Leverages advance problem-solving and analytical skills to identify access and reimbursement barriers while offering actionable insights to desired and approved care</li><li>
Uncover the root cause to access issues impeding or delaying proper treatment</li><li>
Monitor and provide updates on both Region and National Payers. Examples include changes or barriers in medical policy, Prior Authorization requirements, or product acquisition. Apply compliant methods to exchange critical information</li><li>
Work collaboratively and function as a liaison for information between various internal stakeholders such as: Market Access, Center of Excellence, Sales, Marketing, Training, Compliance, Trade, and Specialty Pharmacy groups.</li><li>
Provide customer feedback relating to approval requirements and access to care barriers with AbbVie stakeholders (Market Access, Center of Excellence, Sales, Marketing, Trade, Specialty Pharmacy, Senior Leadership)</li><li>
Educate accounts on need-based tools to support patient access. Examples include HUB services, patient savings programs, payer coverage details, and acquisition pull-through initiatives</li><li>
Proficient in providing analytical and customized need-based solutions to problems in complex environments and matrix influenced health systems and practices</li><li>
Establish and maintain respectful working relationships with healthcare professionals and staff as well as business-oriented decision makers including C-Suite level executives within territory</li><li>
Demonstrates the ability to lead without authority and effectively communicate with diverse groups with sometimes different priorities</li><li>
Capable of influencing across functions to gain consensus on agreed upon patient solutions</li><li>
Ability to professionally deliver crucial conversations that may contain less than desirable information or facts</li><li>
Proactively engage in Field Input Teams offering innovative solutions to problems in a fast-paced changing environment</li><li>
Share customer challenges and suggest potential solutions to address obstacles</li><li>
Demonstrate effective planning, prioritization, follow up, and anticipates problems</li><li>
The employee conducts all work activities in compliance with all Abbvie internal requirements and with all applicable regulatory requirements</li></ul><br>
<b>
Qualifications</b><br>
<ul><li>
A minimum of 5&ndash;7 years of proven success in a health care related field</li><li>
Bachelor&rsquo;s degree required</li><li>
Preferred experience includes Previous Sales, District Management, Hospital, Managed Markets, Access and Reimbursement, or practice experience</li><li>
Knowledge of Lean Six Sigma principles is favorable</li><li>
Exposure to physician-administered injectables, CPT and/or J-code reimbursement, Specialty Pharmacy and Buy &amp; Bill acquisition, Benefit Verifications, Prior Authorizations, Claim Assistance, Appeals and payor policies, and HUB services</li><li>
Proven record of comprehensive work with accounts at all levels</li><li>
Payer/insurance coverage experience with Medicare, Medicare Advantage, Commercial and Medicaid plans</li><li>
Well-developed verbal and written communication skills, including in-person and virtual presentation skills of complex information and processes</li><li>
Proven and consistent competence of the following skills: Problem Solving, Gain Access, Resource Mastery, Tangible Results, Overcoming Adversity, Collaboration, and Managing Complexities</li><li>
Demonstration of key soft skills: Empathy, Critical Thinking, Curiosity, Persistence, Reliability, and Resourcefulness</li><li>
Strong history of leadership within current role</li><li>
Technology and analytical skills (Salesforce, virtual meetings, excel, report interpretation)</li><li>
A Valid Driver&rsquo;s License</li><li>
Ability to travel adequately to cover territory, attend training, and meetings. Some overnight travel may be required</li></ul><p><b>
This role is field-based and candidates should live within a reasonable distance from the primary city. Talent will be hired at a level commensurate with experience. This geography covers three states: IA, NE, and SD.</b></p><b><br>
Additional Information</b><p><br>
Applicable only to applicants applying to a position in any location with pay disclosure requirements under state or local law:
</p><ul><li><p>The compensation range described below is the range of possible base pay compensation that the Company believes in good faith it will pay for this role at the time of this posting based on the job grade for this position. Individual compensation paid within this range will depend on many factors including geographic location, and we may ultimately pay more or less than the posted range. This range may be modified in the future.
</p></li><li><p>We offer a comprehensive package of benefits including paid time off (vacation, holidays, sick), medical/dental/vision insurance and 401(k) to eligible employees.
</p></li><li><p>This job is eligible to participate in our long-term incentive programs.
</p></li></ul><p>Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, incentive, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole and absolute discretion unless and until paid and may be modified at the Company&rsquo;s sole and absolute discretion, consistent with applicable law.
</p><div></div><p>AbbVie is an equal opportunity employer and is committed to operating with integrity, driving innovation, transforming lives and serving our community. Equal Opportunity Employer/Veterans/Disabled.</p><p>
US &amp; Puerto Rico only - to learn more, visit https://www.abbvie.com/join-us/equal-employment-opportunity-employer.html</p><p>
US &amp; Puerto Rico applicants seeking a reasonable accommodation, click here to learn more:</p><p>
https://www.abbvie.com/join-us/reasonable-accommodations.html</p></div>

Field Reimbursement Manager - Botox Therapeutic

Eide Bailly

<div>Overview:
<div><b>
Location:</b> Any state with an Eide Bailly office</div><div><b>
Work Arrangement: </b>In-office, hybrid, or remote with the ability to come into an Eide Bailly office as needed</div><div></div><div><b><i><br>
Typical Day in the Life</i></b></div><div>
In this role, you will lead healthcare financial projects, including Medicare and Medicaid cost report services for a variety of healthcare facilities, while also supporting other reimbursement initiatives as needed. You&rsquo;ll play an active role in developing a strong team that is dedicated to delivering exceptional client service and driving meaningful results for both our clients and Eide Bailly. A typical day as a Healthcare Reimbursement Manager might include the following:</div><ul><li>
Overseeing cost report preparation and reimbursement engagements to ensure objectives are met, including supporting staff development, addressing client needs, and maintaining engagement profitability.</li><li>
Creating meaningful outcomes by outlining engagement objectives, delivering findings, and providing actionable recommendations to clients.</li><li>
Managing client relationships with integrity, identifying needs and creating value driven solutions.</li><li>
Driving growth by participating in staff development, contributing to business development efforts, and expanding market reach.</li><li>
Collaborating with leadership to develop innovative services and strategies for the reimbursement practice.</li><li>
Staying ahead of evolving healthcare rules and regulations, providing clients with trusted insights.</li></ul><div></div><div><b><i><br>
Who You Are</i></b></div><ul><li>
You have a Bachelors degree, preferably in Accounting (CPA preferred but not required).</li><li>
You have 7-10 years of Healthcare Reimbursement experience.</li><li>
You have extensive knowledge of third-party reimbursement and payment methodologies within the healthcare industry.</li><li>
You thrive working independently and excel at balancing multiple projects.</li><li>
You&rsquo;re a clear and confident communicator, both written and verbal.</li><li>
You have strong relationship-building skills, earning trust from both clients and colleagues.</li><li>
You&rsquo;re tech-savvy with Microsoft Office (Excel pivot tables and formulas are second nature), and you&rsquo;re quick to adapt to new software tools.</li><li>
You&rsquo;re results-driven, detail-oriented, and consistently deliver on deadlines.</li></ul><div></div><div><i><br>
Must be authorized to work in the United States now or in the future without visa sponsorship.</i></div><div></div><div><b><i><br>
Making an Impact Together</i></b></div><div>
People join Eide Bailly for the opportunities and stay because of the culture. At Eide Bailly, we've built a collaborative workplace based on integrity, authenticity, and support for one another. You'll find opportunities for education and career growth, a team dedicated to your success, and benefits that put your family's needs first. Hear what our employees have to say about working at Eide Bailly.</div><div><br>
</div><div><b><i>Compensation: $95,000-$135,000</i></b></div><div>
Our compensation philosophy emphasizes competitive and equitable pay. Eide Bailly complies with all local/state regulations regarding displaying ranges. Final compensation decisions are dependent upon factors such as geography, experience, education, skills, and internal equity.</div><div></div><div><b><i><br>
Benefits</i></b></div><div>
Beyond base compensation, Eide Bailly provides benefits such as: generous paid time off, comprehensive medical, dental, and vision insurance, 401(k) profit sharing, life and disability insurance, lifestyle spending account, certification incentives, education assistance, and a referral program.</div><div></div><div><b><i><br>
Next Steps</i></b></div><div>
We'll be in touch! If you look like the right fit for our position, one of our recruiters will be reaching out to schedule a phone interview with you to learn more about your career interests and goals. In the meantime, we encourage you to learn more about us on Facebook, Twitter, Instagram, LinkedIn or our About Us page.</div><div></div><div><br>
For extra assistance in your job search journey, explore EB Career Resources&mdash;a complimentary external tool that offers career exploration, resume workshops, interview prep and other professional development options.</div><div></div><div><i><br>
Eide Bailly LLP is proud to be an affirmative action/equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, veteran status, or any other status protected under local, state or federal laws.</i></div><div></div><div><br>
#LI-MB1</div><div>
#LI-REMOTE</div></div>

Healthcare Cost Reporting/Reimbursement Manager - Remote Eligible

<div><p>We are the leading provider of professional services to the middle market globally, our purpose is to instill confidence in a world of change, empowering our clients and people to realize their full potential. Our exceptional people are the key to our unrivaled, culture and talent experience and our ability to be compelling to our clients. You&rsquo;ll find an environment that inspires and empowers you to thrive both personally and professionally. There&rsquo;s no one like you and that&rsquo;s why there&rsquo;s nowhere like RSM.</p><p></p><p>
RSM&rsquo;s National Healthcare Consulting practice is searching for a <b>Healthcare Regulatory Manager</b> who will provide healthcare regulatory and reimbursement consulting services to clients, potential clients and centers of influence. RSM&rsquo;s Healthcare Regulatory recovery services are designed to identify high-impact Medicare cost report-related opportunities, including Medicare Critical Access Hospitals, PPS hospitals disproportionate share, bad debts, wage index and other related issues.</p><p></p><p>
As a member of the National Healthcare Consulting practice, you will join professionals with a broad knowledge of the healthcare industry including: financial analysis, regulatory reporting and compliance, and healthcare technology. You will be part of a collaborative consulting team to deliver exceptional client service to meet our client's objectives.</p><p></p><p><b>
Responsibilities</b><b>:</b></p><ul><li>
Work with clients regarding regulatory, compliance, strategies, and other business needs.</li><li>
Work interactively with clients and client team members to create deliverables.</li><li>
Assist in the development of training materials for client personnel related to any new processes/systems</li><li>
Assist in creating, managing, and executing project work plans to provide high-quality client service delivery.</li><li>
Assist in preparing and maintaining internal and external project status reports</li><li>
Assist in leading and directing support staff on projects to prioritize work tasks, ensuring project milestones and deadlines are met, and ensuring work products meet quality standards</li><li>
Mentor junior team members in industry best practices for implementation and project management</li><li>
Support sales activity with new and existing clients by participating in meaningful conversations regarding current challenges while representing RSM&rsquo;s capabilities.</li></ul><p></p><p><b>
Basic Qualifications</b><b>:</b></p><ul><li>
Bachelor's degree in accounting, finance or related field.</li><li>
5+ years of health care reimbursement &amp; regulatory experience, consulting experience desirable</li><li>
Hands-on experience completing Medicare, Medicaid &amp; Blue Cross reimbursement reports.</li><li>
Strong knowledge of third-party reimbursement procedures.</li><li>
Previous practice development experience.</li><li>
Strong project management skills.</li><li>
Strong leadership and management experience.</li><li>
Strong skills in Microsoft Office software and industry-related software programs</li><li>
Proven experience leading and/or supervising client service teams</li><li>
Ability and willingness to travel</li></ul><p></p><p><b>
Preferred Qualifications</b></p><ul><li>
Ability to analyze and interpret financial data.</li><li>
Ability to read, analyze and interpret industry information and regulations.</li><li>
Ability to build strong relationships and work well with others.</li><li>
Ability to understand the economics of the firm's consulting practice.</li><li>
Exceed client expectations, accurate and timely completion of projects and/or reports.</li><li>
Successful in obtaining consulting services from new and existing clients.</li><li>
Professional representation of the firm and the services provided.</li><li>
Excellent time management and organizational skills.</li><li>
Effective in working independently.</li><li>
Exceptional oral, written, communication and facilitation skills.</li><li>
Interpersonal relationships which encourage openness, candor and trust, both internally and outside the organization.</li><li>
Initiative and creative thinking in decision-making, problem resolution situations and the performance of job duties.</li></ul><p></p><p>
At RSM, we offer a competitive benefits and compensation package for all our people. We offer flexibility in your schedule, empowering you to balance life&rsquo;s demands, while also maintaining your ability to serve clients. Learn more about our total rewards at https://rsmus.com/careers/working-at-rsm/benefits.</p><p></p><p>
All applicants will receive consideration for employment as RSM does not tolerate discrimination and/or harassment based on race; color; creed; sincerely held religious beliefs, practices or observances; sex (including pregnancy or disabilities related to nursing); gender; sexual orientation; HIV Status; national origin; ancestry; familial or marital status; age; physical or mental disability; citizenship; political affiliation; medical condition (including family and medical leave); domestic violence victim status; past, current or prospective service in the US uniformed service; US Military/Veteran status; pre-disposing genetic characteristics or any other characteristic protected under applicable federal, state or local law.</p><p></p><p>
Accommodation for applicants with disabilities is available upon request in connection with the recruitment process and/or employment/partnership. RSM is committed to providing equal opportunity and reasonable accommodation for people with disabilities. If you require a reasonable accommodation to complete an application, interview, or otherwise participate in the recruiting process, please call us at 800-274-3978 or send us an email at careers@rsmus.com.</p><p></p><p>
RSM does not intend to hire entry level candidates who will require sponsorship now OR in the future (i.e. F-1 visa holders). If you are a recent U.S. college / university graduate possessing 1-2 years of progressive and relevant work experience in a same or similar role to the one for which you are applying, excluding internships, you may be eligible for hire as an experienced associate.</p><p></p><p>
RSM will consider for employment qualified applicants with arrest or conviction records. For those living in California or applying to a position in California, please click here for additional information.</p><p></p><p>
At RSM, an employee&rsquo;s pay at any point in their career is intended to reflect their experiences, performance, and skills for their current role. The salary range (or starting rate for interns and associates) for this role represents numerous factors considered in the hiring decisions including, but not limited to, education, skills, work experience, certifications, location, etc. As such, pay for the successful candidate(s) could fall anywhere within the stated range.</p><p></p>
Compensation Range: $112,100 - $225,500<p></p><div><div><div><div><div><div><div><div><div><div><div><div><div><div><p>
Individuals selected for this role will be eligible for a discretionary bonus based on firm and individual performance.</p></div></div></div></div></div></div></div></div></div></div></div></div></div></div></div>

Manager, Healthcare Reimbursement and Regulatory Risk Consulting

Nemours Children's Health

<div><b>Nemours is seeking a Sr. Medical Reimbursement Analyst in Jacksonville, FL.</b><p>
The primary function of the Senior Medical Reimbursement Analyst is the resolution of open high dollar insurance balances through collections. The position is responsible for researching unpaid, underpaid and denied high dollar insurance claims then applying contractual billing and payment guidelines to ensure timely resolution and meet collection goals. The position also uses knowledge of the revenue cycle to analyze, report and work reimbursement issues with various internal departments and external entities at all levels to create reliable methods for future resolution.
</p><p><b>Essential Functions<br>
</b><br>
</p><ul><li>Work accounts until all charges are paid or denied by the insurance carrier, while utilizing their ability to multitask, maintain process efficiencies and production levels.
</li><li>Understand and apply principles of reimbursement to all aspects of the revenue cycle including but not limited to billing, coding, reimbursement, recovery, and patient responsibility.
</li><li>Account for high dollar balances and keep abreast of insurance trends while identifying and reporting payor trends and issues to management and huddle board in order to affect timely resolution.
</li><li>Pursue payment from payors related to both denials and underpayment through various means of communication including verbal and written platforms i.e email, appeals, etc.
</li><li>Accurately enter patient demographics, guarantor and coverage information into Epic system. As well as, accurately perform retro adjudication, change filing order, request necessary adjustments / reversal of adjustments, or refile claims.
</li><li>Apply problem solving skills to resolve discrepancies while maintaining a professional demeanor that promotes patient, staff and customer satisfaction, and reflects the Mission, Vision, and Values of Nemours when working with either insurers or the insured.
</li><li>Work jointly with all departments along the revenue cycle to resolve issues, including attending meetings both internally and externally. Building relationships which could result in an increase of collection % as well as, ensure timely processing of claims.
</li><li>Keep abreast of all insurance and system changes, Payor Plan Standards, contractual updates, etc.
</li><li>Apply balance adjustments as appropriate and accurately bill the guarantor for patient responsibility if applicable.
</li></ul><p><b>Requirements</b></p><p>
High School Diploma</p><p>
1-3 years of experience</p><p><b>
About Us</b></p><p>
Nemours Children's Health is an internationally recognized pediatric health system serving more than 1.7 million patient encounters each year. We deliver care across six states through two freestanding children's hospitals - Nemours Children's Hospital, Delaware and Nemours Children's Hospital, Florida - along with a network of more than 80 primary, urgent, and specialty care practices and more than 40 hospital partnerships.</p><p>
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.</p><p>
Inclusion and belonging guide our strategy and growth. We are committed to culturally relevant care, reducing health disparities, and fostering an environment where every associate, patient, and family feels supported and valued.</p><p>
Learn more at Nemours.org .</p></div>

Medical Reimbursement Analyst Sr

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Healthcare Cost Reporting/Reimbursement Manager - Remote Eligible

Manager, Healthcare Reimbursement and Regulatory Risk Consulting

Medical Reimbursement Analyst Sr