Job Description

Description:
Remote Medical Bill Processor, you will work from your home office, and ensure World Trade Center Health Program members' medical claims are paid timely and in accordance with Program Regulations and Guidelines. You will work with utilization review (UR) nurses to identify the most appropriate treatment based on industry standards and Program-related conditions. In this process, you will use our proprietary claims processing system containing clinical edits.

Responsibilities
Keys pre-coded billing data into the system.
Identifies and escalates complex bills per documented guidelines.
Codes provider bills in accordance with claims management system notes and program guidelines
Compares provider network status and qualifications with service provided.
Performs other duties as assigned.
Supports the organization's quality program(s).
Must be a US Citizen

Requirements :
Position will be Remote - East Coast Hours observed.
Temps needed for anticipated Start Date tentatively in April 2025
Duration: 90 days and will re-assess and possible extension at that date. Temp to Perm if inventory warrants.
Days: Monday - Friday, for Training Shift 8 AM - 4:30 PM Eastern Time, Once candidate finishes training, their hours will be flexible as some staff prefer to start at 6:30 am or 7:00 am – we are flexible after training

Location: Remote

MANAGER NOTES:
For this position, need a candidate with claims processing knowledge, data entry and if they have coding knowledge would be a plus as well. Position starts as data entry to gain knowledge of the program and system and once quality and production is met, we move on to processing claims.

Qualifications
High School diploma or GED required.
US Citizen

We will need experienced bill processors with a good knowledge of claims - One (1) year of general office experience or equivalent combination of education and experience required. Knowledge of medical terminology is preferred. Prior medical bill review preferred.

Excellent oral and written communication
PC literate, including Microsoft Office products
Analytical and interpretive skills
Strong organizational skills
Good interpersonal skills
Ability to work in a team environment
Ability to meet or exceed Performance Competencies

Must be a US Citizen

Nesco Resource offers a comprehensive benefits package for our associates, which includes a MEC (Minimum Essential Coverage) plan that encompasses Medical, Vision, Dental, 401K, and EAP (Employee Assistance Program) services.

Nesco Resource provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

Job Tags

Permanent employment, Temporary work, Local area, Remote job, Home office, Flexible hours, Shift work, Monday to Friday,

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