Remote Healthcare Claims Analyst II

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

Benefits offered by this job

Medical, dental & vision

401(k) Retirement Plan

Time Off/Leave (PTO)

HSA

Job summary

TEKsystems seeks a detail-focused Claims Analyst II for our healthcare claims operations. You will review and process professional and institutional claims, ensure coding accuracy, and resolve complex reimbursements to meet quality standards.

Ideal candidates have 2–4 years in healthcare claims processing, strong analytical skills, and familiarity with CPT/ICD-10 coding. This remote role supports the US healthcare ecosystem with competitive benefits.

Qualifications

• Minimum 2–4 years in healthcare claims processing/claims administration.
• Experience reviewing and adjudicating both professional and facility medical claims.
• Strong knowledge of healthcare reimbursement practices and claims payment methodologies.

Responsibilities

• Review professional and institutional claims per plans and guidelines.
• Determine outcomes: payment, denial, adjustment, or review.
• Verify accuracy, coding, and supporting documentation.
• Ensure timely, accurate payments per service standards.
• Handle COB, workers' comp, and subrogation claims.
• Communicate with providers, members, and internal teams to resolve issues.

Skills

Claims processing

Medical terminology

Coding (CPT/ICD-10)

COB knowledge

Subrogation procedures

Claims software

Analytical skills

Education

High school diploma or GED

Tools

QNXT

Healthcare claims platforms

Job description

TEKsystems seeks a detail-focused Claims Analyst II for our healthcare claims operations. You will review and process professional and institutional claims, ensure coding accuracy, and resolve complex reimbursements to meet quality standards.

Ideal candidates have 2–4 years in healthcare claims processing, strong analytical skills, and familiarity with CPT/ICD-10 coding. This remote role supports the US healthcare ecosystem with competitive benefits.