Description:
As a Remote Medical Bill Processor, you will work from your home office, ensuring World Trade Center Health Program members' medical claims are paid timely and in accordance with Program Regulations and Guidelines. You will collaborate 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.
Remote Bill Processor 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).
Requirements:
Position will be Remote - East Coast Hours observed.
Temps needed for anticipated Start Date tentatively 12/2/2024 or earlier.
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, we need a candidate with claims processing knowledge, data entry experience, and coding knowledge would be a plus. The position starts as data entry to gain knowledge of the program and system, and once quality and production are met, we move on to processing claims.
Remote Bill Processor Qualifications:
- High School diploma or GED required.
- 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 is preferred.
- Excellent oral and written communication skills.
- 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.
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.
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