Claims Processor (Wisconsin Only)

TEKsystems; United States; Remote; USD 22,000 - 31,000; Full time

Benefits offered by this job

Medical benefits

Dental & vision

401(k)

Paid time off

Job summary

TEKsystems is seeking a remoteClaims Analyst in Wisconsin to review, adjudicate, and process medical claims. The role requires 2–4 years of claims processing experience, strong coding knowledge (CPT/ICD-9/ICD-10), and attention to detail in a production environment.

The position is contract-to-hire with full-time hours and a 40-hour work week. Training is virtual for 6 weeks, and the pay rate is $19.25 per hour. Eligibility for benefits and remote work options within Wisconsin are noted.

Qualifications

• 2–4 years of medical claims processing experience.
• Experience adjudicating professional and facility medical claims.
• Knowledge of CPT, ICD-9, ICD-10 coding.
• Familiarity with healthcare claims processes and medical terminology.
• Experience with Coordination of Benefits (COB) and subrogation.

Responsibilities

• Review and adjudicate paper and electronic medical claims.
• Determine approval, denial, pended, suspended, or returned status.
• Process professional and facility claims per plans and policies.
• Verify claim accuracy, coding, and documentation.
• Investigate and resolve pending claims within turnaround times.
• Identify COB, workers' compensation, and subrogation-related claims.
• Monitor systems for errors and correct as needed.
• Apply provider discounts and contract-based reimbursements.
• Process specialty claims including transplant and COB.

Skills

Medical claims processing

CPT coding

ICD-9/ICD-10 coding

COB and subrogation

Analytical skills

Communication skills

Tools

QNXT Claims Workflow

Job description

Claims Analyst (Medical Claims Processing)

Location: Remote within Wisconsin (must be able to pick up equipment from the Menasha or Brookfield office)

Job Type: Contract-to-Hire

Schedule: Full-Time, 40 hours/week, Monday-Friday

Training Schedule: 8:00 AM - 4:30 PM for the first 6 weeks (virtual training)

Pay Rate: $19.25/hour

Overview

We are seeking an experienced Claims Analyst to join a growing healthcare operations team. This position is responsible for reviewing, analyzing, and adjudicating medical claims while ensuring compliance with benefit plans, medical policies, and established processing guidelines. The ideal candidate will have prior medical claims processing experience, strong attention to detail, and the ability to work efficiently in a production-driven environment.

Key Responsibilities

• Review and adjudicate paper and electronic medical claims.
• Determine whether claims should be approved, denied, pended, suspended, or returned for additional information.
• Process professional and facility claims in accordance with benefit plans and medical policies.
• Verify claim accuracy, coding, billing standards, and completeness of documentation.
• Investigate and resolve pending claims within established turnaround times.
• Identify and process Coordination of Benefits (COB), Workers' Compensation, and subrogation-related claims.
• Monitor claims processing systems for errors and make necessary corrections.
• Apply provider discounts, pricing adjustments, and contract-specific reimbursement methodologies.
• Process specialty claims, including transplant and COB claims.
• Maintain accurate documentation and claim notes.
• Meet established productivity, quality, and accuracy standards.
• Collaborate with internal teams to resolve claim issues and support operational goals.

Required Qualifications

• 2-4 years of medical claims processing experience.
• Experience adjudicating professional and facility medical claims.
• Knowledge of CPT, ICD-9, and ICD-10 coding.
• Familiarity with medical terminology and healthcare claims processes.
• Experience with Coordination of Benefits (COB) and subrogation.
• Strong analytical and problem-solving skills.
• Excellent attention to detail and accuracy.
• Ability to meet productivity and quality metrics in a high-volume environment.
• Strong written and verbal communication skills.

Preferred Qualifications

• Experience with QNXT Claims Workflow.
• Experience supporting ACA, Medicaid, or other health plan environments.
• Medical coding experience.
• Experience with claims repricing and network reimbursement methodologies.
• Knowledge of provider contracts, benefit plans, and utilization management processes.

Work Environment

This role offers flexibility with remote work for candidates residing in Wisconsin. Employees may work remotely, onsite, or in a hybrid capacity. Reliable internet access is required, and candidates must be able to pick up company equipment from the Menasha or Brookfield office.

What We're Looking For

Successful candidates are detail-oriented professionals who thrive in a fast-paced claims environment, can interpret complex healthcare policies and billing information, and consistently maintain high levels of accuracy while meeting performance expectations.

Apply today if you have medical claims processing experience and are looking for an opportunity to grow with a healthcare organization that values quality, accuracy, and operational excellence.

#centralpriority26

Job Type & Location

This is a Contract to Hire position based out of Waukesha, WI.

Pay and Benefits

The pay range for this position is $19.25 - $19.25/hr.

Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors.

Eligibility requirements apply to some benefits and may depend on your jobclassification and length of employment. Benefits are subject to change and may besubject to specific elections, plan, or program terms. If eligible, the benefitsavailable for this temporary role may include the following:Medical, dental & visionCritical Illness, Accident, and Hospital401(k) Retirement Plan Pre-tax and Roth post-tax contributions availableLife Insurance (Voluntary Life & AD&D for the employee and dependents)Short and long-term disabilityHealth Spending Account (HSA)Transportation benefitsEmployee Assistance ProgramTime Off/Leave (PTO, Vacation or Sick Leave)

Job Type & Location

This is a Contract to Hire position based out of Waukesha, WI.

Application Deadline

This position is anticipated to close on Nov 12, 2026.

Workplace Type

This is a fully remote position.

About TEKsystems

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

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

About TEKsystems and TEKsystems Global Services

Were 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. Were 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. Were strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. Were 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.

San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.

Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.