Nemours is seeking Credit Resolution Specialist (Full-Time), to join our team in Jacksonville, Florida.

The primary function of this position is to reconcile accounts receivable credit balances on sequences, in undistributed, unapplied and suspense accounts through the correct application of payments and adjustments and issuing refunds to guarantors, insurance and third-party payers as well as initiating takeback requests when appropriate or as specified in the contracts with insurance.

Job Responsibilities:

• Responsible for researching and resolving credits by following established policies and procedures and adding the appropriate codes and narrative notes into the Epic system.
• Responsible for processing correspondence and refund requests through extensive phone, fax, and written communication with payers and other agencies.
• Reviews reimbursement rates before adjusting or refunding.
• Requests refunds of accounts receivable credits in Epic.
• Generates check request for refunds to customers when appropriate and submit to AP.
• Identifies any patterns or issues with payers and reports them back to supervisor. Communicates proposed resolution if any, to responsible parties.
• Voids any incorrect information and reposts them correctly into the system.
• Verifies eligibility/coverage for patient insurance.
• Works unidentified payments in Suspense accounts
• Maintains production and accuracy to meet the minimum established goals individually and for the team.
• Other duties as assigned.

Job Requirements

• High School Diploma required.
• Minimum (6) six months of experience required.