Medical Claims Examiner - Adjudication & Compliance

Hornet Staffing, Inc, a GEE Group company; Irving (TX); On-site; USD 52,000 - 68,000; Full time

Job summary

Hornet Staffing, Inc, a GEE Group company is seeking an experienced healthcare claims processor in Irving, TX. The role focuses on processing and adjudicating UB-04 and CMS-1500 claims with strict adherence to payer guidelines and HIPAA rules.

The ideal candidate has 3+ years in healthcare claims processing, exceptional attention to detail, and strong communication and problem-solving abilities. You will collaborate with internal teams to ensure timely and accurate claim resolution.

Qualifications

• 3 years of Healthcare Claims Processing experience
• Hands-on experience processing and adjudicating UB-04 and CMS-1500 claims
• Knowledge of healthcare payer guidelines
• Strong attention to detail and data accuracy
• Understanding of HIPAA regulations
• Excellent communication and problem-solving skills
• Process and adjudicate healthcare claims accurately and efficiently
• Review UB-04 and CMS-1500 claims
• Resolve claim pend and denial issues
• Respond to provider and customer inquiries
• Maintain quality, compliance, and productivity standards
• Collaborate with internal teams to ensure timely claim processing

Responsibilities

• Process and adjudicate healthcare claims accurately and efficiently
• Review UB-04 and CMS-1500 claims
• Resolve claim pend and denial issues
• Respond to provider and customer inquiries
• Maintain quality, compliance, and productivity standards
• Collaborate with internal teams to ensure timely claim processing

Skills

Healthcare claims processing

Attention to detail

Data accuracy

Communication skills

Problem solving

HIPAA regulations knowledge

Team collaboration

Tools

UB-04

CMS-1500

Job description

Hornet Staffing, Inc, a GEE Group company is seeking an experienced healthcare claims processor in Irving, TX. The role focuses on processing and adjudicating UB-04 and CMS-1500 claims with strict adherence to payer guidelines and HIPAA rules.

The ideal candidate has 3+ years in healthcare claims processing, exceptional attention to detail, and strong communication and problem-solving abilities. You will collaborate with internal teams to ensure timely and accurate claim resolution.