TEKsystems · 1 day ago
Claims Director
Concord, CA
Full-time
Hybrid
Lead/Staff, Director/Executive
$75/hr - $80/hr
5+ years expTEKsystems is a leading provider of business and technology services, and they are seeking a Claims Director to lead claims operations for Contra Costa Health Plan. This role involves overseeing a team, driving strategy, optimizing workflows, and ensuring compliance with regulatory requirements in claims processing.
Information Technology
Responsibilities
Lead and manage all claims operations, including adjudication, adjustments, and payment integrity
Oversee and coach managers and supervisors; ensure team performance and development
Optimize workflows and implement process improvements for efficiency
Manage vendor relationships and Epic Tapestry system enhancements (training provided)
Ensure compliance with Medi-Cal, Medicare, and regulatory requirements
Monitor KPIs for timeliness, accuracy, and compliance
Collaborate with Provider Relations, Finance, Compliance, IT, and other departments
Address provider disputes and billing questions; support positive provider relationships
Lead initiatives for backlog reduction, performance improvement, and system optimization
Qualification
Required
Experience leading claims operations in a health plan environment
Strong understanding of Medi-Cal and Medicare requirements
Ability to translate regulations into operational strategies
Comfortable presenting complex issues to leadership and external partners
Familiarity with claims systems (Epic Tapestry experience is a plus)
Bachelor's degree in business, finance, or related field
5+ years in healthcare management, with at least 3 years in claims or patient financial services
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,
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