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Billing Specialist

Company: Nesco Resource, LLC
Location: Canton
Posted on: May 28, 2023

Job Description:

The Billing Specialist's primary responsibilities include the submission of professional medical claims to all appropriate payers under the Medicaid program. It is a position that is critical for the financial cycle of the Agency, from My Care Ohio payers through payers associated with state and federal programs.

Essential Duties & Responsibilities

  • Verify with Branch Managers that billing is approved and ready to create.
  • Verify payer eligibility monthly before the billing cycle.
  • Verify billing codes and modifiers necessary to receive prompt payment.
  • Prepare, review, create and transmit claims using billing software, including electronic and paper claim processing when necessary.
  • Review unpaid claims, correct and re-bill when needed.
  • Research and appeal denied claims.
  • Post all payments monthly in billing software system.
  • Review billing reports monthly.
  • Maintain communication with clearing house and insurance payers regarding any discrepancy in payments.
  • Research and appeal denied claims.
  • Run collection reports.
  • Maintain software updates when applicable.
  • Meet monthly deadlines.
  • All other duties as assigned.


    • High school diploma or GED required; at least three (3) years of home care medical billing required.
    • Compliance and ethics, as well as process efficiency.
    • Ability to communicate effectively in a transparent and timely manner both orally and in writing.
    • Must have a strong technical aptitude and attention to detail.
    • Must have excellent problem-solving and organizational skills.

      Physical Demands
      Must be able to remain in a stationary position 50% of the time. Needs to occasionally move about the inside of the office to access file cabinets, office machinery, etc., and bend or stand as necessary. Constantly operates a computer and other office productivity machinery, such as a calculator, copy machine, and computer printer. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets, and fax machines. Occasionally positions self to move boxes or equipment weighing 25 pounds or less. Frequently communicates with fellow employees, clients, associates, etc. Must be able to perceive objects at a distance and up close. Must be able to travel for short or extended periods to other locations as needed for specific meetings, or to other business locations related to business.
      Nesco Resource and affiliates (Lehigh G.I.T Inc, and Callos Resource, LLC) is an equal employment opportunity employer and does not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, or veteran status, or any other legally protected characteristics with respect to employment opportunities.


Keywords: Nesco Resource, LLC, Canton , Billing Specialist, Accounting, Auditing , Canton, Ohio

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