Third-Party Medical Claims Processor

Hire Up Staffing Services; Fresno (CA); On-site; USD 25,000 - 28,000; Full time

Job summary

Hire Up Staffing Services in Fresno, CA is seeking a skilled Medical Biller / Claims Processor for a full-time, on-site role. Workweek is Monday to Friday, 7:00 AM to 4:00 PM, with pay ranging from $18 to $20 per hour depending on experience.

Prior TPA exposure is highly preferred for handling group benefit processing. The ideal candidate has a minimum of 3 years in medical billing or claims processing, strong accuracy, and the ability to interpret SPD benefits and perform zero-dollar

Qualifications

• At least 3 years in medical billing or claims processing.
• Experience with third-party administrator (TPA) is highly preferred.
• Proficiency with CMS-1500 and UB-04 is a plus.

Responsibilities

• Manage claims across multiple groups with accuracy and speed.
• Process CMS-1500 and UB-04 claims.
• Handle high-dollar claims and track progress via reporting tools.
• Verify claims using vendor portals and verify SPD benefits.
• Maintain confidentiality and communicate via email.

Skills

Medical Billing

Claims Processing

TPA experience

Email/Confidentiality

Education

High School Diploma or GED

Job description

Don’t miss this amazing opportunity with one of our best employers in Fresno! Exciting Opportunity for a Medical Biller / Claims Processor in Fresno, CA! We are seeking a skilled Medical Biller or Claims Processor to join one of our top employers in Fresno, CA. This full-time, on-site position runs Monday to Friday from 7:00 AM to 4:00 PM, offering competitive pay ranging from $18 to $20 per hour, depending on experience.

Ideal Candidate

The perfect fit for this role has at least 3 years of experience in medical billing or claims processing—especially if that experience includes working with a third-party administrator (TPA) within an insurance company. Prior TPA exposure is highly preferred due to the nature of this employer’s group benefit processing.

Job Requirements

• High School Diploma or GED required
• Minimum of 3 years of experience in a computerized medical billing or claims processing environment

Key Responsibilities

• Manage claims across multiple groups with accuracy and speed
• Process CMS-1500 and UB-04 claims
• Accurately handle high-dollar claims
• Work with JAA/BlueCard claims
• Interpret group SPD’s and apply benefits appropriately
• Perform zero-dollar adjustments and review flagged claims
• Maintain accurate reporting and resolve issues via FOGBUGZ
• Use tools like the Anthem Blue Cross website for claims verification
• Batch and scan correspondence
• Track spreadsheets for special projects
• Maintain excellent email communication and confidentiality