Research and resolve unpaid, underpaid, and denied insurance claims by reviewing coding, billing, contracts, and authorization terms, and applying appropriate collection, appeal, and adjustment processes. Maintain accurate account documentation and data in Epic, allocate payments correctly, report denial trends, and support patients and customers with account inquiries.
The Inpatient Hospital Coder is responsible for accurately assigning codes for diagnoses, procedures, and drug administration using AHA and CPT guidelines. They also facilitate clinical documentation modifications to ensure captured information supports the level of service rendered and risk adjustment factors.
The radiologist will provide state-of-the-art diagnostic and interventional pediatric radiology services across the Nemours health system. Responsibilities include participating in multi-site conferences, shared worklists, and after-hours coverage.
The architect will lead the strategy, design, and delivery of technology solutions for laboratory medicine with a focus on digital pathology. They will partner with stakeholders to ensure systems are secure, scalable, and aligned with enterprise standards.
The Professional Fee Abstractor is responsible for 100% charge capture by reviewing physician documentation and applying accurate medical codes. They must also manage EPIC charge review work queues and participate in physician education regarding documentation guidelines.
Ensure 100% charge capture by reviewing physician notes and assigning correct CPT and ICD-10 codes. Act as a liaison between providers and the billing office to resolve claim issues and provide coding education.
Provide 100% pediatric diagnostic imaging services as a remote nighthawk radiologist. Work in a paired overnight model to support multiple pediatric hospitals across several states.
The coordinator ensures compliance with research protocols, federal regulations, and ICH-GCP guidelines through internal monitoring and data review. They are also responsible for developing training programs and providing educational opportunities for clinical research associates.
