TEKsystems · 1 day ago
REMOTE Claims Examiner
United States
Full-time
Remote
New Grad, Entry Level
$24/hr - $27/hrTEKsystems is a leading provider of business and technology services, helping clients activate ideas and solutions. They are seeking a detail-oriented Claims Examiner to manage D-SNP claims processing, ensuring compliance with regulatory guidelines and maintaining accurate documentation.
Information Technology
Responsibilities
Research, correct, and respond to all D-SNP pended claims in a timely manner
Review audit reports and determine claim payment eligibility in accordance with policies and procedures
Maintain accurate correspondence and documentation for medical procedures, CPT, and HCFA codes
Review, price, and release claims for assigned claim types (paper and electronic)
Analyze Manual Review reports for suspended D-SNP claims
Stay current on all D-SNP policies and contribute to departmental improvement projects
Ensure compliance with all regulatory guidelines and monitor adherence
Maintain daily activity logs and assist with claims processing
Perform additional duties and special projects as assigned
Qualification
Required
Prior experience in high-volume production environments
Excellent oral and written communication skills
Strong attention to detail
Preferred
Medical terminology and/or coding experience highly desirable
Claims Processing
Project Management
Healthcare Operations
Workflow Optimization
Medical Terminology & Coding
QNXT platform proficiency
Strong knowledge of D-SNP program
Expertise in dual eligible claims processing (Medi-Cal and Medicare D-SNP)
Benefits
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)
Company
TEKsystems
At TEKsystems, they understand people. Every year they deploy over 80,000 IT professionals at 6,000 client sites across North America,
Founded in 1994
10001+ employees
H1B Sponsorship
TEKsystems has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (46)
2024 (52)
2023 (33)
2022 (22)
2021 (36)
2020 (53)
Funding
Current Stage
Late StageLeadership Team
Ryan Skains
Vice President, TEKsystems Global Services
Recent News
2025-11-19
2025-10-29
Company data provided by crunchbase