Claims Analyst

TEKsystems; Menasha (WI); Remote; USD 60,000 - 80,000; Full time

Job summary

A leading company in technology services is seeking a Claims Analyst II to work remotely from Wisconsin. The role involves examining and processing various claims, ensuring compliance with policies, and requires specific healthcare claims experience. This is an excellent opportunity for individuals with a strong background in claims processing and medical terminology.

Benefits

Medical, dental & vision

401(k) Retirement Plan

Life Insurance

Short and long-term disability

Health Spending Account (HSA)

Transportation benefits

Employee Assistance Program

Time Off/Leave

Qualifications

• 1.5-4 years claims processing experience required.
• Knowledge of current procedural terminology (CPT) and ICD-9/ICD-10.
• Coding experience preferred.

Responsibilities

• Examine and process paper claims and/or electronic claims.
• Determine whether to return, pend, deny or pay claims.
• Resolve claim issues according to established policies.

Skills

Healthcare claims processing experience

Knowledge of CPT and ICD-9/ICD-10

Medical terminology

COB processing

Subrogation

Education

High school diploma or equivalent

Tools

QNXT Claims Workflow

Job description

TEKsystems is seeking claims analysts to join our clients team in Wisconsin. This position is 100% work from home, but candidates MUST reside in Wisconsin ONLY.
*Description*
As a Claims Analyst II you will be tasked with the following:

* Examine and process paper claims and/or electronic claims.
* The person in this role determines whether to return, pend, deny or pay claims within established policies and procedures.
* Determines steps necessary for adjudication.
* Follows established departmental policies and procedures, operating memos and corporate policies to resolve claim and claim issues.
* Settles claims with Claimants in accordance with policy provisions.
* Compares claims application and/or provider statement with policy file and other records to evaluate completeness and validity of claim.
* Pays claimant's amount due.
*Skills & Qualifications*

* High school diploma or equivalent
* 1.5-4 years claims processing experience required (healthcare related)
* Knowledge of current procedural terminology (CPT) and international classification of diseases (ICD-9 and ICD-10). Medical terminology, COB processing, subrogation.
*Highly Prefer Skills:*

* Coding experience preferred.
* Past experience using QNXT Claims Workflow a plus
Hours: Monday - Friday between 8:00am - 5:00pm
*Pay and Benefits*
The pay range for this position is $19.25 - $19.25/hr.
Eligibility requirements apply to some benefits and may depend on your job
classification and length of employment. Benefits are subject to change and may be
subject to specific elections, plan, or program terms. If eligible, the benefits
available for this temporary role may include the following:
* Medical, dental & vision
* Critical Illness, Accident, and Hospital
* 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available
* Life Insurance (Voluntary Life & AD&D for the employee and dependents)
* Short and long-term disability
* Health Spending Account (HSA)
* Transportation benefits
* Employee Assistance Program
* Time Off/Leave (PTO, Vacation or Sick Leave)
*Workplace Type*
This is a fully remote position.
*Application Deadline*
This position is anticipated to close on Jun 11, 2025.
About TEKsystems and TEKsystems Global Services

We're a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We're a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We're strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We're building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.


The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.