Claims Examiner

TEKsystems
$25.00 / hr
life insurance, sick time, 401(k), retirement plan
United States, California, Los Angeles
Sep 07, 2025
Job Title: Claims Examiner - Contract Role Location: Northridge, CA (Relocating to West Hills in November 2025) Work Arrangement: On-site only - this is not a remote position Schedule: Monday-Friday, 6:00 AM-2:30 PM* (Flexible after training; overtime available) Start Date: Estimated to start - September 30, 2025 Contract Duration: 4-6 months with possibility of extension Pay: $25/hour Position Overview We are seeking a detail-oriented Claims Examiner for a short-term contract role. This position is ideal for professionals with experience in HMO and Medicare claims who are looking to contribute to a high-performing team. You'll be responsible for auditing claims, analyzing benefits, and supporting compliance and auto-adjudication processes. Key Responsibilities Audit denied provider claims (13/hour) and member claims (10/hour). * Conduct benefit analysis and review system design. * Manage special projects related to claims compliance and auto-adjudication. * Track and trend outcomes; report findings to management. * Collaborate with project managers and leadership to resolve process issues. * Maintain documentation and workflow oversight with minimal supervision. Required Skills & Experience * 2-5 years of experience processing HMO claims and understanding regulatory guidelines. * Strong knowledge of Medicare claims and CPT codes. * Familiarity with claims systems, preferably EZCap. * Experience with claims examining, resubmission, and audits. * Proficiency in Excel and other Microsoft Office tools. * Ability to work independently and prioritize tasks. * Strong analytical, communication, and organizational skills. * Comfortable working in a team of 8 auditors and cross-functional staff. Preferred Qualifications * Experience with Medicare guidelines and health plan operations. * Experience in claims system configuration and operational efficiency. * Ability to interpret both qualitative and quantitative data. Training & Onboarding * 90-day ramp-up period to meet full expectations. * Training includes shadowing and job aids. Pay and Benefits The pay range for this position is $25.00 - $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 Los Angeles,CA 91325. Application Deadline This position is anticipated to close on Sep 12, 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.