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SUMMARY:

Provide call center callers with timely, accurate, and customer-focused claim information, solicit information needed to perfect the claim, consistently deliver a superior level of customer service, document the claim system, work with the Supplemental Health and Limited Medical Benefit products, and perform well in a call center team environment.

Required Skills & Abilities:

+ Minimum of 2 years of Supplemental Health or Medical claims experience required.

+ Minimum of 2 years of experience in a call center environment, within the health/medical insurance claims industry.

+ Previous experience with HFCA 1500 & UB04 claim forms

+ Proven experience with CPT/ICD 10 Coding. Ability to recognize CPT & revenue cycle codes.

+ Must have a high school diploma or GED.

+ Proficiency in MS Office applications

Details:

+ 100% Remote | Equipment Provided. Applicants must provide the internet and a quiet workspace.

+ Schedule: Monday to Friday | 8:30 – 5:00pm (PST). (45-minute lunch break, 38.5 hours per week)

+ Pay: $18 - $20/hr. based on related experience

+ Pay cycle – Weekly | Medical, Dental & Vision Benefits offered.

Key Responsibilities:

+ Customer Service Calls: Provide customers with timely, accurate, and customer-focused benefit and claim information.

+ Handling inbound and outbound calls related to Scheduled Accident, Critical Illness, and Hospital Indemnity claims.

+ Solicit and enter the information needed to enter and process claims accurately and in a timely manner.

+ Record summaries of information exchanged in our claim system with a high level of accuracy and detail easily understood by the user.

+ Issue timely and accurate claim acknowledgement correspondence.

+ Process incoming documents with high coding integrity and distribute immediately.

+ Remain fully compliant with operational standards.

+ Meet or exceed call center operational metrics.

+ Claims Registration: Enter incoming claims information with high degree of accuracy, meeting or exceeding established metrics.

+ Comprehensively review and evaluate appeal and complaint requests to identify and classify member and provider appeals.

+ Determine eligibility, benefits, and prior activity related to the claims, payment, or service in question.

+ Research appeal files for completeness and accuracy and investigate deficiencies.

Pay and Benefits

The pay range for this position is $18.00 - $20.00/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 13, 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.