Remote Healthcare Claims Analyst II

TEKsystems; United States; Hybrid; USD 22,000 - 31,000; Full time

Benefits offered by this job

Comprehensive virtual training program

Flexible work options (remote/onsite/h

Job summary

TEKsystems is seeking a detail-oriented Claims Analyst II to join our Wisconsin-based team. The role involves reviewing, analyzing, and processing medical claims while ensuring accuracy, compliance with health plan policies, and adherence to procedures.

Remote within Wisconsin, onsite in Madison, or hybrid options are available. Ideal candidates have 2–4 years of medical claims processing experience, CPT/ICD coding knowledge, COB, and strong analytical skills.

Qualifications

• 2–4 years of medical claims processing experience.
• Familiarity with CPT coding, ICD-9/ ICD-10, and COB.
• Knowledge of subrogation processes.
• Strong analytical and detail-oriented problem-solving skills.

Responsibilities

• Process professional and facility medical claims for payment per plan benefits.
• Review claims for accuracy and compliance with billing standards.
• Determine payment, denial, return, or pend decisions per guidelines.
• Investigate and resolve pending claims within set timeframes.
• Identify COB, workers' compensation, and subrogation claims.
• Maintain accurate records and confidentiality.

Skills

CPT coding

ICD-9/ICD-10

Medical terminology

COB

Subrogation processes

Analytical skills

Independent work

Job description

TEKsystems is seeking a detail-oriented Claims Analyst II to join our Wisconsin-based team. The role involves reviewing, analyzing, and processing medical claims while ensuring accuracy, compliance with health plan policies, and adherence to procedures.

Remote within Wisconsin, onsite in Madison, or hybrid options are available. Ideal candidates have 2–4 years of medical claims processing experience, CPT/ICD coding knowledge, COB, and strong analytical skills.