"Alerted.org

Schedule: Monday–Friday, 8:00 AM–4:30 PM or 8:30 AM–5:00 PM

About the Role

Seeking a detail-oriented and experienced Claim Processor to join our growing team. This role is critical to our Medicaid line of business expansion and involves processing healthcare claims with accuracy and efficiency. If you have a strong experience in claims processing and Medicaid, we’d love to hear from you!

Key Responsibilities

+ Examine and process both paper and electronic healthcare claims.

+ Determine appropriate action: 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.

+ Use 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 - $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 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 Jul 24, 2025.

h4>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.