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Healthcare Claims Analyst

2 months ago

Fort Worth, Texas, United States CornerStone Staffing Full time
Job Overview

CornerStone Staffing is collaborating with a prominent healthcare organization to identify a skilled Healthcare Claims Analyst.

We are seeking candidates with a solid background in hospital claims processing and manual data entry.

Position Details:
Location: Remote after initial training
Job ID: 146836
Employment Type: Direct Hire
Compensation: $20-$21/hr (commensurate with experience)

Role Summary:
The Healthcare Claims Analyst will be tasked with analyzing and monitoring claims audit data across various systems. This role involves conducting follow-up activities to ensure the accuracy and appropriateness of reimbursements to healthcare providers. Key responsibilities include identifying payment discrepancies and collaborating with internal and external parties to resolve these issues.

Key Responsibilities:

  • Claims Review & Adjustment: Evaluate, modify, and reprice claims to guarantee accurate reimbursement in accordance with contractual agreements and payer guidelines.
  • Pricing Management: Establish and maintain accurate pricing frameworks to support competitive and profitable billing practices.
  • Error Resolution: Identify and rectify discrepancies in reconciliation files across multiple platforms and partners.
  • Contract Analysis: Conduct detailed variance assessments and identify overpayments or billing inaccuracies.
  • Data Insights: Analyze claims data, produce reports, and support trend analysis to ensure precise revenue cycle information.
  • Compliance Adherence: Remain updated on billing protocols, federal and state regulations, and internal policies.
  • Confidentiality Maintenance: Uphold strict confidentiality of medical records and personal data.

Work Schedule:
Select any 8-hour shift from Monday to Friday, between 8 am and 5 pm.

Essential Qualifications:

  • Experience: At least 3 years in claims processing, repricing, pricing configuration, or provider maintenance.
  • Education: High School Diploma or equivalent (verification required).
  • Technical Proficiency: Skilled in MS Office (Word, Excel, PowerPoint, Outlook) and Windows operating systems.
  • Knowledge Base: Strong understanding of healthcare revenue cycle, claims reimbursement, ICD-10 coding, and CMS guidelines.
  • Analytical Skills: Exceptional problem-solving capabilities and attention to detail.

Additional Requirements:

  • Ability to work independently and think critically.
  • Proven knowledge of billing and coding regulations.
  • Strong analytical skills and ability to deliver results in a fast-paced environment.

Why Choose CornerStone Staffing?

  • Career Advancement: Direct hire opportunity with a reputable healthcare organization.
  • Flexibility: Enjoy the advantages of remote work following initial training.

Ready to contribute to the healthcare claims processing field? We look forward to your application.