Claims Examiner- FULLY REMOTE!
TekSystems is currently hiring for a FULLY REMOTE Claims examiner contract position! THIS POSITION CAN START ASAP! MUST HAVE: 1-3 years of recent medical claims experience or something related! Description Reviewing Claims Documentation - Examine submitted claims for completeness, accuracy, and compliance with policy terms. - Verify supporting documents such as medical records, police reports, or receipts. Determining Claim Validity - Assess whether claims meet criteria for approval based on policy coverage. - Investigate potential fraud, inconsistencies, or discrepancies. Calculating Benefit Amounts - Determine appropriate payout amounts based on policy limits and deductibles. - Ensure all calculations are accurate, justified, and documented. Communicating with Stakeholders - Contact claimants, healthcare providers, or other relevant parties to gather additional information. - Provide timely updates and clear explanations regarding claim decisions. Maintaining Records - Document all actions taken during the claim review process. - Ensure records are organized and compliant with regulatory and company standards. Collaborating with Other Departments - Partner with adjusters, underwriters, and legal teams as needed. - Refer complex or high-risk cases for further investigation or legal review. Skills customer service, healthcare industry, claims processing, medical billing, claims analysis Top Skills Details customer service,healthcare industry Additional Skills & Qualifications - Ability to communicate effectively and professionally with personnel, in both written and verbal form. - Must possess a strong attention to detail and an interest in preventing errors. - Ability to operate a personal computer (PC) and other office equipment (e.g., copy machine, fax machine, printer, calculator, etc.) as well as possess excellent keyboarding skills. - Demonstrate ability to be dependable and professional. - Demonstrate intrinsic initiative and time management skills. - Must possess a strong commitment to teamwork and an ability to foster an inclusive culture of diversity by working well and collaborating with others as needed. - Ability to accept feedback, learn, and adapt from guidance to be successful. - Ability to adapt to consistently changing priorities and keep daily responsibilities on task. - Ability to manage workload and ensure all tasks are completed within established timeframes. - Must be willing and able to work possible mandatory overtime as needed based on business needs. - Must be able to meet quality, productivity, and behavior expectations. - Must possess basic reading and arithmetic skills (reading and math comprehension). Pay and Benefits The pay range for this position is $17.00 - $17.00/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 Oct 21, 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 mom