As one of the nation’s leading pediatric health care systems, Nemours is committed to providing all children with their best chance to grow up healthy. We offer integrated, family-centered care to more than 300,000 children each year in our pediatric hospitals, specialty clinics and primary care practices in Delaware, Florida, Maryland, New Jersey and Pennsylvania. Nemours strives to ensure a healthier tomorrow for all children – even those who may never enter our doors – through our world-changing research, education and advocacy efforts. At Nemours, our Associates help us deliver on the promise we make to every family we have the privilege of serving: to treat their child as if they were our own.
Nemours is seeking a Billing Specialist I (Full-Time) to join our team in Jacksonville, Florida.
At Nemours, each Associate plays a vital role in supporting the delivery of world-class pediatric care to the children we serve. The team based at our home office in Jacksonville, Fla. provides essential administrative, financial and technical support to Nemours operations across all locations.
Perform the assigned duties of a billing representative for the clinic and hospital, accurately handling billing and claim information in a timely fashion.Provide service to internal and external customers as a member of the Patient Financial Services team.
Maintain a working knowledge of and follow Patient Financial Services and clinic/hospital policies and procedures.
Process encounters, prebilling worksheets and claims on a daily basis. Process charge review work queue and router review work queue on a daily basis.
Review, validate, update and correct, if necessary, demographic and insurance information on specific claims and on patient accounts. All posted charges and encounters should be reviewed.
Communicate with coworkers, management, and providers regarding charges for clinics and any billing problems that arise.
Post charges for assigned divisions.
Interact with coworkers and clinic personnel in a productive and cooperative manner.
Work as an integral member of a team to cover related functions in all areas of billing and coding.
Work with all team members to be more efficient and productive.
Establish and maintain a working relationship with individuals outside of your immediate area, (Registration, PSS, Precert, Cashier, and Insurance Companies).
Maintain working knowledge of the authorization and precertification processes.
Notify Management of detected errors, particularly patterns of errors or inaccuracies for all files and documentation.
Be courteous and alert to all internal and external customers.
Round to hospital & Clinical Divisions on a daily basis to collect charge information.
Effectively pull, assign and relate diagnosis codes to procedure codes to support medical necessity from provider documentation.
Daily balancing of hash totals.
High School Diploma required.
Minimum of one (1) year experience in billing, preferably in a physician’s office/hospital or with a health insurance company.
Customer service experience preferred.
Proficient in health insurance knowledge including benefit verification and understanding of plan requirements for accurate claim filing.
Excellent computer skills and ability to navigate the Internet.
Demonstrate ability to organize and prioritize responsibilities.
Demonstrate positive attitude and ability to get along with others.
Excellent attendance and reliability to effectively complete all duties in a timely manner.
Our dedication to professionals who are dedicated to children frequently earns Nemours a spot on the list of top workplaces in the communities we serve. Our Associates enjoy comprehensive benefits, including our unique “Bridge to a Healthy Future” pediatric health plan, an integrated wellness program, opportunities for professional growth, and much more. As an equal opportunity employer, Nemours focuses on the best-qualified applicants for our openings.
Nemours is a pediatric health system of hospitals and specialty clinics serving children and families throughout the Delaware Valley and Florida. Our dedicated professionals integrate medical care, research, health education, and prevention to help improve the lives of children every day.