Remote Claims Processor

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

Job summary

A leading company in technology services is seeking a Claims Analyst II for a fully remote position. The role involves examining and processing claims, resolving issues, and ensuring compliance with policies. Candidates should have experience in healthcare claims processing and knowledge of medical coding.

Benefits

Medical, dental & vision

401(k) plan with pre-tax and Roth options

Life Insurance (Voluntary Life & AD&D)

Short and long-term disability

HSA

Transportation benefits

Employee Assistance Program

PTO, Vacation, Sick Leave

Qualifications

• 1.5-4 years of healthcare claims processing experience required.
• Knowledge of medical terminology and coding (CPT, ICD-9, ICD-10).

Responsibilities

• Examine and process paper and electronic claims.
• Determine whether to return, pend, deny, or pay claims.
• Resolve claim issues and process payments to claimants.

Skills

Healthcare claims processing

Knowledge of CPT

Knowledge of ICD-9

Knowledge of ICD-10

Knowledge of medical terminology

COB processing

Subrogation

Education

High school diploma or equivalent

Job description

*MUST BE LOCATED IN WISCONSIN*

*Fully Remote*

Description

As a Claims Analyst II, you will be responsible for examining and processing paper and electronic claims. You will determine whether to return, pend, deny, or pay claims based on established policies and procedures. Your role involves adjudication steps, resolving claim issues following departmental and corporate policies, settling claims with claimants, and evaluating claim completeness and validity by comparing application and provider statements with policy records. Additionally, you will process payments to claimants.

Additional Skills & Qualifications

MUST:

• High school diploma or equivalent preferred.
• 1.5-4 years of healthcare claims processing experience.
• Knowledge of CPT, ICD-9, ICD-10, medical terminology, COB processing, and subrogation.

Pay and Benefits

The pay range is $19.25/hr. Eligibility for benefits depends on job classification and employment length, and benefits may change. Available benefits include:

• Medical, dental & vision
• Critical Illness, Accident, and Hospital insurance
• 401(k) plan with pre-tax and Roth options
• Life Insurance (Voluntary Life & AD&D)
• Short and long-term disability
• HSA
• Transportation benefits
• Employee Assistance Program
• PTO, Vacation, Sick Leave

Workplace Type

This is a fully remote position.

Application Deadline

Anticipated closing date: June 6, 2025.

About TEKsystems and TEKsystems Global Services

We are a leading provider of business and technology services, helping clients accelerate transformation through strategy, design, execution, and operations. With 80,000 employees serving over 6,000 clients worldwide, including 80% of the Fortune 500, we deliver scalable solutions and business outcomes. We are committed to building tomorrow and making positive impacts globally. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.

The company is an equal opportunity employer, considering all applications regardless of race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information, or any characteristic protected by law.