Remote Claims Processor

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

Job summary

Lensa's client TEKsystems is seeking a Claims Analyst II to manage electronic and paper claims processing remotely from Wisconsin. This entry-level role involves evaluating claims according to company policies, ensuring adherence to medical and legal standards. Candidates with relevant experience in claims processing and knowledge of insurance terminology are encouraged to apply.

Benefits

Medical, dental & vision insurance

401(k) Retirement Plan

Life Insurance (Voluntary Life & AD&D)

Short and long-term disability coverage

Health Spending Account (HSA)

Transportation benefits

Employee Assistance Program

Paid Time Off and Leave

Qualifications

• 1.5-4 years claims processing experience required.
• Sound knowledge of procedural terminology & medical terms essential.

Responsibilities

• Examine and process claims.
• Determine steps necessary for adjudication.
• Resolve claim issues per established policies.

Skills

Knowledge of CPT and ICD-9/ICD-10

Claims processing

Medical terminology

COB processing

Subrogation

Education

High school diploma or equivalent

Job description

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MUST BE LOCATED IN WISCONSIN

Fully Remote

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.
  
  

Must

Additional Skills & Qualifications

• High school diploma or equivalent preferred.
• 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.
  
  

Pay and Benefits

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

Requirements

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 May 31, 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.

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Other

• Industries

  IT Services and IT Consulting

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