New

Claims Examiner

TEKsystems
$21.00 - $24.00 / hr
life insurance, sick time, 401(k), retirement plan, remote work
United States, California, Fresno
Jun 06, 2025
We Are Looking for a Claims Examiner! Location: Remote (On-site training in Fresno, CA) - must live within a 60 mile radius of Fresno Job Type: Full-Time Hours \| Remote After Training Department: Claims \| Reports to: Claims Manager Why You'll Love Working With One of Our Top Healthcare Clients Are you passionate about making a difference in healthcare? Do you thrive in a fast-paced, detail-oriented environment? We're looking for a Claims Examiner who's ready to grow their career, contribute to a collaborative team, and enjoy the flexibility of remote work. Our client believes in supporting our employees with the tools, training, and culture they need to succeed. After completing your initial training in their Fresno office, you'll transition to a 100% remote role-with ongoing support and a team that's got your back. What You'll Do * As a Claims Examiner, you'll play a key role in ensuring our members receive accurate and timely claim processing. You'll: * Review and process medical, dental, vision, and HIPD claims with precision and care. * Analyze documentation, verify pricing, and confirm prior authorizations. * Collaborate with internal teams to resolve claim issues and ensure compliance. * Interpret plan documents to determine benefits and adjudicate claims accurately. * Identify trends, flag potential compliance issues, and contribute to process improvements. What We're Looking For * High school diploma or equivalent. * 1-3 years of experience in health claims processing (medical, dental, vision, subrogation, or accident). * Familiarity with UB-04, HCFA 1500, ICD-10, CPT, and HCPCS codes. * Strong attention to detail and problem-solving skills. * Proficiency in Microsoft Office and 10-key by touch (40 WPM typing speed). * Ability to adapt in a dynamic, fast-paced environment. * Knowledge of ERISA guidelines is a plus! Perks & Benefits * 100% Remote Work after training * On-site Training Support in Fresno, CA * Collaborative, Team-Oriented Culture * Make a Real Impact in the lives of members and providers Your Future Starts Here If you're ready to take the next step in your healthcare career and want to be part of a team that values quality, collaboration, and innovation-apply today! Pay and Benefits The pay range for this position is $21.00 - $24.00/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 Jun 19, 2025. 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.