Join Our Team as a Claim Processor!
Location: Remote (Must reside in Wisconsin)
Schedule: Monday–Friday, 8:00 AM–4:30 PM or 8:30 AM–5:00 PM
About the Role
Are you detail-oriented and experienced in claims processing? We are looking for a Claim Processor to join our dynamic team! This role is essential for our Medicaid line of business expansion, where your expertise will help us process healthcare claims with precision and efficiency. If you have a strong background in claims processing and Medicaid, we want to hear from you!
Key Responsibilities
* Examine and process both paper and electronic healthcare claims.
* Determine appropriate actions: return, pend, deny, or pay claims per policy.
* Adjudicate claims following established procedures and timelines.
* Review claims for completeness, billing accuracy, and policy compliance.
* Investigate and resolve pending claims, including COB, Workers’ Compensation, and Subrogation.
* Process specialty claims (e.g., transplant, URN, COB) and apply appropriate pricing.
* Maintain production and quality standards while ensuring confidentiality.
* Utilize internal systems (e.g., QNXT™) and external re-pricing tools as needed.
* Document claim decisions and maintain accurate records.
Required Qualifications
* High school diploma or equivalent.
* 1.5+ years of healthcare claims processing experience.
* Familiarity with CPT, ICD-9/10, and medical terminology.
* Experience with COB processing and subrogation.
* Experience with Medicaid and/or Medicare claims.
Why Join Us?
* Inclusive Culture: We value diversity and are committed to creating an inclusive environment for all employees.
* Remote Flexibility: Work from the comfort of your home while making a meaningful impact.
* Growth Opportunity: Be part of a growing team supporting our Medicaid expansion.
Pay and Benefits
The pay range for this position is $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:
* Medical, dental & vision
* Critical Illness, Accident, and Hospital coverage
* 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 July 24, 2025.
About TEKsystems
We are partners in transformation, helping clients activate ideas and solutions to seize new opportunities. With a team of 80,000 strong, we work 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 and Talent Services, we collaborate with progressive leaders to drive change. That’s the power of true partnership.
TEKsystems is an equal opportunity employer and welcomes applications from all individuals 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.