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Government Contracts Managed Care Specialist

Experience Level: Intermediate

Schedule: M-F 07:00 - 04:00 PM

Position Summary

The Government Contracts Managed Care Specialist supports the Government Contracts Managed Care Supervisor in resolving complex reimbursement issues, managing government payer accounts, and ensuring accurate and timely payment for hospital services. This role requires strong knowledge of Medi‑Cal, CCS, and government payer regulations, as well as experience with hospital/acute care billing and collections.

Key Responsibilities

+ Analyze and interpret Commercial, Medi‑Cal, CCS, and Government payer contracts, including terms, conditions, payment structures, and responsibility matrices.

+ Conduct proactive telephone and written follow‑up with government insurance payers and providers to resolve outstanding claims.

+ Ensure all payers comply with regulatory timely filing and processing requirements, escalating issues as needed.

+ Apply strong understanding of Managed Care reimbursement principles, payer rules, and federal/state regulations from both third‑party and patient‑responsibility perspectives.

+ Review individual accounts to determine information needs, claim barriers, or required documentation, and secure payment commitments or resolution timelines.

+ Follow through on all payer requests to remove claim obstacles and secure reimbursement.

+ Escalate unresolved or complex issues to Management or Payer Relations when barriers cannot be removed at the specialist level.

+ Develop and implement payer‑specific collection and recovery strategies to maximize reimbursement and reduce aging accounts for assigned hospitals.

+ Perform full-cycle denials management (appeals, reconsiderations, documentation review) from initiation to final resolution.

+ Review aging reports, audit collections, identify trends, and recommend process improvements.

+ Work with high‑cost and specialized claims, including cancer treatments and Proton Therapy charges.

Required Skills & Qualifications

+ 2+ years of hospital or acute‑care collections experience, specifically working with Medi‑Cal and government payer billing.

+ Experience with CCS, Medi‑Cal, Medicare, Medicare Advantage, and government payer guidelines.

+ Strong knowledge of medical collections, reimbursement rules, and Managed Care principles.

+ Understanding of medical billing and coding practices and common denial reasons.

+ Ability to analyze contracts, interpret payer policies, and identify reimbursement discrepancies.

+ EPIC experience preferred (not required).

+ Strong communication skills with the ability to professionally engage payers in both written and verbal formats.

+ Ability to work independently, manage aging accounts, and pursue claims aggressively to closure.

Job Type & Location

This is a Contract position based out of SAN BERNARDINO, CA.

Pay and Benefits

The pay range for this position is $22.00 - $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 Type

This is a fully onsite position in SAN BERNARDINO,CA.

Application Deadline

This position is anticipated to close on Jan 23, 2026.

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.