New

Claims Examiner

TEKsystems
$23.00 - $25.00 / hr
life insurance, sick time, 401(k), retirement plan

Jun 28, 2026
Job Summary We are seeking an experienced Claims Examiner to join our team. In this role, you will be responsible for researching, reviewing, correcting, and resolving pended medical claims while ensuring compliance with company policies, procedures, and regulatory guidelines. The ideal candidate will have prior claims examination experience and a strong understanding of medical claims processing, claims adjudication, and denial management. Key Responsibilities * Research, review, and resolve pended medical claims in a timely and accurate manner. * Determine claim payment eligibility based on established policies, procedures, and benefit guidelines. * Analyze and adjudicate medical claims while ensuring accuracy and compliance. * Review audit reports and take appropriate corrective actions as needed. * Investigate and respond to claim discrepancies, denials, and processing issues. * Maintain correspondence related to required documentation, medical records, CPT codes, HCFA forms, and other claim-related information. * Ensure adherence to regulatory requirements and organizational compliance standards. * Collaborate with internal departments to resolve claim issues and improve processing efficiency. * Document findings and maintain accurate records of claim reviews and determinations. Required Qualifications * High School Diploma or equivalent. * Previous experience as a Claims Examiner. * Experience with medical claims processing and claims adjudication. * Knowledge of medical billing and coding concepts. * Ability to review and interpret claim documentation and medical records. * Strong analytical, problem-solving, and decision-making skills. * Excellent attention to detail and organizational skills. Preferred Qualifications * Experience handling medical claim denials and appeals. * Working knowledge of CPT, HCFA, and medical coding standards. * Experience reviewing audit reports and ensuring regulatory compliance. * Prior experience within a healthcare payer, insurance, or managed care environment. Key Skills * Claims Examination * Medical Claims Processing * Claims Adjudication * Claims Denials Management * Medical Billing & Coding * CPT & HCFA Knowledge * Regulatory Compliance * Audit Review * Analytical Problem Solving * Attention to Detail Job Type & Location This is a Contract position based out of Santa Barbara, CA. Pay and BenefitsThe pay range for this position is $23.00 - $25.00/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 TypeThis is a fully remote position. Application DeadlineThis position is anticipated to close on Jul 10, 2026. 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 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. San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records. Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability. Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.