Claims Processor

4 weeks ago

Fort Worth, United States CornerStone Staffing Full time

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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