Claims Processor
CornerStone Staffing, Fort Worth, TX, United States
CornerStone Staffing is partnering with a leading healthcare company in Fort Worth to find a talented Claims Processor/Revenue Cycle Analyst.
If you have experience in processing hospital claims and manual data entry, we want to hear from you!
Location: Fort Worth, TX (2 weeks of on-site training, then 100% Remote)
Job ID: 147394
Employment Type: Temp to Hire
Pay Range: $19/hr (based on experience)
Flexible Hours: Monday and Friday, 8 am to 5 pm.
Position Overview: The Claims Processor is responsible for analysis and monitoring of claims audit data across multiple platforms. Performs various follow-up activities to ensure the accuracy and appropriateness of reimbursement made to healthcare providers. Responsibilities include identifying payment variances and working internally and externally to resolve such issues.
Key Responsibilities:
Claims Analysis & Adjustment: Review, adjust, and reprice claims to ensure accurate reimbursement per contractual agreements and payer guidelines.
Pricing Structures: Develop and maintain precise pricing structures to support competitive and profitable billing strategies.
Error Identification: Detect and resolve errors in reconciliation files across various platforms and partners.
Contract & Reimbursement Analysis: Perform detailed variance analysis and identify overpayments or billing errors.
Data Analysis: Analyze claims data, generate reports, and support trend analysis to ensure accurate revenue cycle data.
Regulatory Compliance: Stay current on billing protocols, federal and state regulations, and internal procedures.
Confidentiality: Maintain strict confidentiality of medical records and personal information.
Essential Skills & Qualifications:
Experience: Minimum of 3 years in claims processing, repricing, pricing configuration, or provider maintenance.
Education: High School Diploma or equivalent (verification required).
Technical Skills: Proficiency in MS Office (Word, Excel, PowerPoint, Outlook) and Windows operating systems.
Knowledge: Strong understanding of healthcare revenue cycle, claims reimbursement, ICD-10 coding, and CMS guidelines.
Analytical Skills: Excellent problem-solving abilities and attention to detail.
Additional Requirements:
Ability to work independently and think critically.
Demonstrated knowledge of billing and coding regulations.
Strong analytical skills and ability to deliver results in a fast-paced environment.
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