What are the responsibilities and job description for the Senior Claims Examiner position at CornerStone Staffing?
Senior Claims Examiner
LOCATION: Irving, TX | Onsite
COMPENSATION & SCHEDULE
• Pay: $22.54 - $24.15/hour (W2)
• Schedule: Monday-Friday | 8:00 AM - 5:00 PM
• Temp to Hire, W2
• Start Date: July 27, 2026
ROLE IMPACT
Join a healthcare organization supporting accurate and timely medical claims adjudication. In this role, you will resolve complex claims, ensure compliance with federal regulations, and help maintain high-quality payment accuracy while partnering with cross-functional teams to improve claims operations.
RESPONSIBILITIES
• Review, analyze, and resolve complex medical claims in accordance with established guidelines and federal regulations.
• Process professional and institutional claims submitted on CMS-1500 and CMS-1450/UB-04 claim forms.
• Review claims from physicians, hospitals, home health agencies, laboratories, and durable medical equipment providers.
• Investigate overpayments and underpayments, complete claim adjustments, process provider refunds, reconsiderations, and member reimbursement requests.
• Support system testing, process improvements, and serve as a resource for claims processing questions while meeting quality and productivity standards.
MINIMUM QUALIFICATIONS
• Associate Degree required (proof of education required).
• Minimum 3 years of medical claims processing experience, including CMS-1500 and CMS-1450/UB-04 claims.
• Strong knowledge of medical claims adjudication, reimbursement methodologies, and federal regulations.
PREFERRED SKILLS
• Excellent analytical, organizational, and problem-solving skills.
• Strong computer, data entry, and written/verbal communication skills.
• Ability to manage multiple priorities in a fast-paced environment.
LEGAL NOTICE
• Employment is contingent upon successful completion of a background check (criminal, education, and employment verification), drug screen, clerical testing, and any other required pre-employment screenings.
By applying for this job, you agree to receive calls, AI-generated calls, text messages, or emails from CornerStone and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy at: https://www.cornerstonestaffing.com/privacy