Remote CPC Claims Resolution Specialist

TEKsystems; Houston (TX); Remote; USD 29,000 - 40,000; Part time

Benefits offered by this job

Medical, dental & vision

401(k) plan

Life Insurance

Paid time off

Health Savings Account (HSA)

Transportation benefits

Employee Assistance Program

Job summary

TEKsystems is seeking a contract-based Claims Resolution professional in Houston, TX. The role focuses on determining payment outcomes for medical claims, especially in emergency services like ambulance and air ambulance, with CPC/CPC-A certification required to be active.

The position involves data validation within TEKsystems’ internal claims system, remote work, and a high-volume workflow. Candidates with EOB familiarity and NSA knowledge are preferred.

Qualifications

• Prefers an entry level coding candidate with little coding experience, experience with appeals and extensive experience with EOBs.
• CPC or CPC-A certification must be active / up-to-date.
• Experience coding/billing emergency services (ambulance and non-ambulance) is helpful but not required.
• NSA (No Surprises Act) experience/knowledge is helpful but not required.
• Billers with CPC-A aiming to get into coding with working knowledge of codes and insurance parameters.

Responsibilities

• Make payment determinations for claims and decide the correct party with rationale.
• Review emergency services billing including ambulance and air ambulance scenarios.
• Validate/verify data and choose the appropriate side without actual coding.
• Handle high-volume charts/files in the internal claims system.

Skills

Coding

CPC

CPC-A

Claims resolution

Billing

Electronic health record

Job description

TEKsystems is seeking a contract-based Claims Resolution professional in Houston, TX. The role focuses on determining payment outcomes for medical claims, especially in emergency services like ambulance and air ambulance, with CPC/CPC-A certification required to be active.

The position involves data validation within TEKsystems’ internal claims system, remote work, and a high-volume workflow. Candidates with EOB familiarity and NSA knowledge are preferred.