Medical Claims Processor at Teksystems Global Services LLC

Bakersfield, California, United States -

Full Time

Start Date

Immediate

Expiry Date

23 May, 26

Salary

22.0

Posted On

22 Feb, 26

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Claims Processing, Policy Guidelines Adherence, Claims Routing, Claims Review, Billing Error Identification, Fraudulent Claim Identification, Eligibility Verification, Benefit Calculation, CCS Eligibility Identification, SharePoint Logging, Productivity Maintenance, Quality Maintenance, Organizational Skills, Decision Making, QNXT Experience, Medi-Cal Claims

Industry

IT Services and IT Consulting

Description

Fully remote within the state of California Description Deny inappropriate claims following policy guidelines. Prepare claims that must be routed to other departments for further review. Review difficult claims with guidance from Claims Supervisor. Responsible for identifying billing errors and possible fraudulent claims submissions. Obtain eligibility verification and other health insurance coverage by Internet or POS. Responsible for correct manual calculation of benefits when applicable. Responsible for identifying possible CCS eligible claims for further investigation. Report overpayment refund requests on SharePoint log Maintain productivity and quality in accordance with established guideline. Perform other job-related duties as required. Regular Predictable attendance. Adheres to all company policies and procedures relative to employment and job responsibilities. Additional Skills & Qualifications High School Diploma from an accredited school or equivalent. Minimum of one (1) year medical Claims Examiner processing experience. Individual must have good organizational skills and the ability to make good decisions. Experience with QNXT Experience with Medi-Cal Claims #westpriority26 Job Type & Location This is a Contract to Hire position based out of Bakersfield, CA. Pay and Benefits The pay range for this position is $22.00 - $22.00/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 Mar 7, 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.

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Responsibilities

The processor is responsible for denying inappropriate claims based on policy guidelines, preparing claims for routing, and reviewing difficult claims with supervisory guidance. Duties also include identifying billing errors, possible fraud, verifying eligibility, and calculating benefits manually when necessary.