Medical Bill Processor (Remote)

Job Summary: Remote Medical Bill Processor, you will work from your home office, and ensure 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. 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). Must be a US Citizen Requirements: Position will be Remote - East Coast Hours observed. Days: Monday - Friday, for Training Shift 8 AM - 4:30 PM Eastern Time, Once training is completed, hours will be flexible as some staff prefer to start at 6:30 am or 7:00 am. Remote Bill Processor 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. Remote Benefits: Performance bonus, Paid sick days, Vacation/paid time off, Parking , Employee Referral Program, Paid Holidays About the Company: Nesco Resource, LLC Companies need talent. You want job opportunities. That’s where we come in. We create meaningful connections between companies and candidates, and we’ve been doing it for over 65 years. Our national workforce solutions include contract, contract-to-hire, direct placement services, and managed services for a variety of industries. We employ specialized recruiters focused in Engineering, Information Technology, Accounting & Finance, Administrative & Customer Service, and Manufacturing & Distribution. When you need to find a job, we're your partner. Company Size: 10,000 employees or more Industry: Staffing/Employment Agencies Founded: 1956 Website: https://nescoresource.com/ Apply Job!