Revenue Integrity Specialist I (Remote)
3.
7 Wilmington, DE Wilmington, DE Full-time Full-time 2 days ago 2 days ago 2 days ago Nemours is seeking a Revenue Integrity Specialist I to join our Nemours Children's Health team in Wilmington, Delaware.
This is a remote position.
This position Revenue Integrity Specialist is responsible for ensuring 100% facility charge capture 100% accuracy within Account, Charge Entry, Router and Claim Edit WQ's according to Billing/Payor regulations.
Secondary duties are to ensure front end UB-04 claims according to regulatory guidelines.
Works with payors, charge capture departments, compliance, CBO, and other areas of the Revenue Cycle at AIDHC.
Daily review of payor coverage updates and guidelines is essential.
Reviews, monitors, and completes hospital claims for all elements of the UBO4 billing form according to CMS and specific payor guidelines.
Reviews daily DNB (Discharged Not Final Billed) accounts within assigned work queue(s).
Works closely with Transport department and completes charge capture for Nemours Transport services.
Assists in SP collections recovery, by calling guarantors and verifying insurance benefits.
Provides support to scheduling and registration departments with patient coverage, eligibility, and authorizations.
Works assigned claim edit work queues correcting all errors and warnings to ensure first-time claim accuracy.
Job Requirements High School Diploma required.
Specialized (1 year of training beyond high school) required.
Minimum of one (1) to three (3) years experience required.
Must obtain CRCS-I certification within 12 months of hire.
.
Estimated Salary: $20 to $28 per hour based on qualifications.
7 Wilmington, DE Wilmington, DE Full-time Full-time 2 days ago 2 days ago 2 days ago Nemours is seeking a Revenue Integrity Specialist I to join our Nemours Children's Health team in Wilmington, Delaware.
This is a remote position.
This position Revenue Integrity Specialist is responsible for ensuring 100% facility charge capture 100% accuracy within Account, Charge Entry, Router and Claim Edit WQ's according to Billing/Payor regulations.
Secondary duties are to ensure front end UB-04 claims according to regulatory guidelines.
Works with payors, charge capture departments, compliance, CBO, and other areas of the Revenue Cycle at AIDHC.
Daily review of payor coverage updates and guidelines is essential.
Reviews, monitors, and completes hospital claims for all elements of the UBO4 billing form according to CMS and specific payor guidelines.
Reviews daily DNB (Discharged Not Final Billed) accounts within assigned work queue(s).
Works closely with Transport department and completes charge capture for Nemours Transport services.
Assists in SP collections recovery, by calling guarantors and verifying insurance benefits.
Provides support to scheduling and registration departments with patient coverage, eligibility, and authorizations.
Works assigned claim edit work queues correcting all errors and warnings to ensure first-time claim accuracy.
Job Requirements High School Diploma required.
Specialized (1 year of training beyond high school) required.
Minimum of one (1) to three (3) years experience required.
Must obtain CRCS-I certification within 12 months of hire.
.
Estimated Salary: $20 to $28 per hour based on qualifications.
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