Claims Analyst/Processor

Remote Full-time
MUST LIVE IN WISCONSIN TO BE CONSIDERED Job Description We are seeking a Claims Analyst II to examine and process paper and electronic claims. In this role, you will determine whether to return, pend, deny, or pay claims in accordance with established policies and procedures. Key responsibilities of this position include the following: • Adjudicate claims by following departmental policies, operating memos, and corporate guidelines. • Resolve claims and related issues in compliance with policy provisions. • Compare claims applications and provider statements with policy files and other records to ensure completeness and validity. • Process payments for claims that are approved. Job Responsibilities: • Processes Professional and Facility claims for payment in accordance with members Certificate of Coverage, established medical policies and procedures, and plan benefit interpretation while maintaining a high level of confidentiality. • Reviews claims to ensure compliance with proper billing standards and completeness of information. • Obtains additional information from appropriate person and/or agency as needed. Skills claims processing, claims adjudication, call center, medicaid, Coding Qualifications • High school diploma or equivalent preferred. • 2-4 years claims processing experience required • Knowledge of current procedural terminology (CPT) and international classification of diseases (ICD-9 and ICD-10). Medical terminology, COB processing, subrogation. • Past experience using QNXT™ Claims Workflow a plus • Prior experience with ACA, Medicaid, or similar health plans preferred not required • Coding experience preferred not required Job Type & Location This is a Contract to Hire position based out of Milwaukee, WI. Pay and Benefits The pay range for this position is $19.25 - $19.25/hr. 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 Dec 18, 2025. h4>About TEKsystems: We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company. The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. 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. Apply tot his job
Apply Now →

Similar Jobs

Commercial Liability Claims Specialist

Remote Full-time

Insurance Claims Specialist- Fredericksburg, VA

Remote Full-time

Facility Claim Follow-Up Representative

Remote Full-time

Mortgage Claims Specialist 2

Remote Full-time

Claims Specialist - Executive Claims Specialist - Coverage - Claims-Made

Remote Full-time

Claims Operations Manager

Remote Full-time

Manager, Insurance Claims Solutions

Remote Full-time

Insurance Product Manager, Car

Remote Full-time

Risk and Insurance Manager

Remote Full-time

Field Manager - Xactimate, Disaster Restoration, Abatement

Remote Full-time

Curriculum Developer, Multimedia Specialist (Remote)

Remote Full-time

Work from Home – Earn $1,200-$1,800/Week Recruiting for Our Freight Dispatch Course

Remote Full-time

LinkedIn Content Automation Engineer (Taplio + Content Systems)

Remote Full-time

Experienced Senior Data Analyst and ETL Developer – Remote Career Opportunity in Healthcare Data Management and Insights Generation at blithequark

Remote Full-time

**Experienced Account Strategist, Mid-Market Sales – Unlocking Business Growth with Innovative Digital Solutions at blithequark**

Remote Full-time

BCBA (Board Certified Behavior Analyst)

Remote Full-time

**Experienced Chat Support Associate – Remote Customer Service Representative**

Remote Full-time

Experienced Customer Service Representative for Blithequark – Remote Work Opportunity in Logistics and Shipping Services

Remote Full-time

Data Entry Specialist - Accurate and Efficient Data Processing for blithequark

Remote Full-time

Training Data Specialist (Remote)

Remote Full-time
← Back to Home