Claims Processors
4 weeks ago
CornerStone Staffing is seeking a Claims Processor t hat has experience in processing hospital claims and manually entering claims.
We are currently seeking candidates to work for an excellent Healthcare company in Fort Worth
JOB ID - 144922
Job Title: Claims Processors
DIRECT HIRE
Pay: $20-$23/hr Depending on experience
Location: Will train on site in Fort Worth, TX MUST BE LOCAL TO THE AREA Then will move 100% remote after 1-2 weeks.
Hours: Flexible to work any 8 hour shift between Monday - Friday, 8am-6:30pm
Job Description: The Revenue Cycle Analyst 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. MUST HAVE CLAIMS PROCESSING EXPERIENCE.
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:
Identifies errors in reconciliation files across multiple work streams and business units for multiple sites and with external partners.
Performs contract and reimbursement variance analysis.
Analyzes claims data to identify contractual over payments and billing errors.
Assists department and leadership in obtaining complex information from various financial, clinical and operational systems and data sources.
Establishes and maintains detailed knowledge and documentation of all analysis/data sources within the department.
Analyzes all forms of Revenue Cycle transactions.
Possesses the ability to run standard Revenue Cycle and operations reports in order to answer questions from department/practice managers, vendors, physicians, and other Revenue Cycle stakeholders.
Produces daily, monthly and annual evaluative and statistical reports, analyzing drivers of variances from period to period in order to ensure the integrity and accuracy of revenue cycle data.
Evaluates integrity of client data including actively participating with and supporting the Product and Account Management teams with trend analysis of payment and data variances.
Ensure strict confidentiality of all medical records, PHI, and PII.
Must have experience in processing hospital claims and manually entering claims. Also must have knowledge of understanding of how to read a contract.
-
Provide expertise or general claims support by reviewing, researching, investigating, negotiating, processing, and adjusting hospital and physician claims
-
Reprice bills according to the physician/facility contracts
-
Recent work history that supports excellent organization, problem-solving communication, teamwork, and interpersonal skill
-
Authorize the appropriate payment or refers claims to investigators for further review
-
Conduct data entry and re-work; analyzes and identifies trends and provides reports as necessary
-
Analyzes and adjusts data, determines appropriate codes, fees and ensures timely filing and contract rates are applied.
KNOWLEDGE & SKILLS:
Ability to work independently and use critical thinking.
Detailed knowledge of pay reimbursement methodology for
Detailed knowledge of CPT, HCPCS, revenue codes and ICD-10 CM.
MS Office including Word, PowerPoint, Excel and Outlook; Windows operating system and Internet.
Strong analytical and problem solving skills20
23
EDUCATION/EXPERIENCE:
3+ years of relevant experience or equivalent combination of educations and work experience.
High School Diploma or equivalent required
-
Claims Processor
3 weeks ago
Fort Wayne, United States Physicians Health Plan Of Northern Indiana, Inc Full time**Position Purpose**: This position examines, enters and accurately adjudicates medical, dental, vision, HRA, FLEX, or STD claims based upon coverage, policy and procedural guidelines. May be assigned multiple clients with several lines of coverage. **Primary Responsibilities**: - To perform this job successfully, the individual must be able to perform...
-
Contact Representative
4 days ago
Fort Leonard Wood, United States Military Treatment Facilities Under Dha Full timeThe duties of this position are for the full performance level. The duties at the GS-07 and GS-08 are the same but with closer than normal supervision. Serve as a Contact Representative performing duties such as coordinating beneficiary counseling and assistance, coordinating TRICARE marketing and education to...
-
Contact Representative
3 days ago
Fort Leonard Wood, United States Military Treatment Facilities Under Dha Full timeThe duties of this position are for the full performance level. The duties at the GS-07 and GS-08 are the same but with closer than normal supervision. Serve as a Contact Representative performing duties such as coordinating beneficiary counseling and assistance, coordinating TRICARE marketing and education to include Access to Care at GLWACH, and providing...
-
Line Cook
2 weeks ago
Fort Collins, United States Brinker International Inc Full timeRole Overview Our Heart of House Team Members are responsible for setting the pace for a great shift, every shift. They provide dependable, fast service that is absolutely Chili's. If you take pride in great team work, then we want to hear from you! * Fast hiring process * Flexible part-time or full-time schedule * Growth opportunities * Great team...
-
Line Cook
2 weeks ago
Fort Gratiot, United States Chilis Full timeRole Overview Our Heart of House Team Members are responsible for setting the pace for a great shift, every shift. They provide dependable, fast service that is absolutely Chili's. If you take pride in great team work, then we want to hear from you! Fast hiring process Flexible part-time or full-time schedule Growth opportunities Great team atmosphere and...
-
Line Cook
5 days ago
Fort Lauderdale, United States Chilis Full timeRole Overview Our Heart of House Team Members are responsible for setting the pace for a great shift, every shift. They provide dependable, fast service that is absolutely Chili's. If you take pride in great team work, then we want to hear from you! Fast hiring process Flexible part-time or full-time schedule Growth opportunities Great team atmosphere and...
-
Line Cook
2 days ago
Fort Mill, United States Chili's Grill & Bar Full timeLine Cook - Promenade Chili's 7704 Charlotte Highway Indian Land, SC 29707 Min: $7.25 Hourly | Max: $18.25 Hourly Role Overview Our Heart of House Team Members are responsible for setting the pace for a great shift, every shift. They provide dependable, fast service that is absolutely Chili's. If you take pride in great team work, then we want to hear...
-
Line Cook
1 day ago
Fort Mill, United States Chili's Grill & Bar Full timeLine Cook - Promenade Chili's 7704 Charlotte Highway Indian Land, SC 29707 Min: $7.25 Hourly | Max: $18.25 Hourly Role Overview Our Heart of House Team Members are responsible for setting the pace for a great shift, every shift. They provide dependable, fast service that is absolutely Chili's. If you take pride in great team work, then we want to hear...
-
Prep Cook
2 months ago
Fort Gratiot Township, United States Chili's Full timeRole Overview Our Heart of House Team Members are responsible for setting the pace for a great shift, every shift. They provide dependable, fast service that is absolutely Chili's. If you take pride in great team work, then we want to hear from you! Fast hiring process Flexible part-time or full-time schedule Growth opportunities Great team...