Claims Processor
4 days ago
CornerStone Staffing is partnering with a leading healthcare company to find a talented Claims Processor/Revenue Cycle Analyst.
This role involves analysis and monitoring of claims audit data across multiple platforms, ensuring accurate reimbursement to healthcare providers.
Key responsibilities include:
- 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 and qualifications include:
- 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.
To be successful in this role, you should be able to work independently and think critically, with a strong analytical mind and ability to deliver results in a fast-paced environment.
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Fort Worth, Texas, United States CornerStone Staffing Full timeCornerStone Staffing is partnering with a leading healthcare company to find a skilled Claims Processor/Revenue Cycle Analyst.This role involves analyzing and monitoring claims audit data across multiple platforms, ensuring accurate reimbursement to healthcare providers.Key responsibilities include:Claims analysis and adjustment to ensure accurate...
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