Remote Claims Analyst II: Adjudicate & Pay

TEKsystems; Milwaukee (WI); Remote; USD 22,000 - 31,000; Full time

Benefits offered by this job

Medical, dental & vision

401(k) Retirement Plan

Life Insurance

Paid time off

Job summary

TEKsystems seeks a Claims Analyst II to examine and process paper and electronic claims, deciding to return, pend, deny, or pay in line with policies. You will adjudicate, resolve issues, verify completeness, and process payments for approved claims.

The role emphasizes compliance with policy, COB/subrogation awareness, and maintaining confidentiality while handling professional and facility claims in a remote setting.

Qualifications

• 2-4 years medical claims processing experience required.
• Knowledge of CPT and ICD-9/ICD-10 medical terminology and COB processing.
• Prior experience with ACA, Medicaid or similar health plans preferred.
• Coding experience preferred.

Responsibilities

• Processes Professional and Facility claims for payment according to policies.
• Reviews claims for billing standards and information completeness.
• Obtains additional information from appropriate parties as needed.
• Maintains department quality standards and processing turnaround times.

Skills

Medical claims processing

CPT/ICD knowledge

COB/subrogation knowledge

QNXT Claims Workflow

Education

High school diploma or equivalent

Job description

TEKsystems seeks a Claims Analyst II to examine and process paper and electronic claims, deciding to return, pend, deny, or pay in line with policies. You will adjudicate, resolve issues, verify completeness, and process payments for approved claims.

The role emphasizes compliance with policy, COB/subrogation awareness, and maintaining confidentiality while handling professional and facility claims in a remote setting.