[Remote] Claims Examiner- FULLY REMOTE!

Note:The job is a remote job and is open to candidates in USA. TEKsystems is a leading provider of business and technology services, and they are seeking a Claims Examiner for a fully remote contract position. The role involves reviewing claims documentation for accuracy and completeness, assessing claim validity, calculating benefit amounts, communicating with stakeholders, and maintaining organized records. Responsibilities • Examine submitted claims for completeness, accuracy, and compliance with policy terms.• Verify supporting documents such as medical records, police reports, or receipts. • Assess whether claims meet criteria for approval based on policy coverage. • Investigate potential fraud, inconsistencies, or discrepancies. • Determine appropriate payout amounts based on policy limits and deductibles. • Ensure all calculations are accurate, justified, and documented. • Contact claimants, healthcare providers, or other relevant parties to gather additional information. • Provide timely updates and clear explanations regarding claim decisions.• Document all actions taken during the claim review process. • Ensure records are organized and compliant with regulatory and company standards. • Partner with adjusters, underwriters, and legal teams as needed. • Refer complex or high-risk cases for further investigation or legal review. Skills • 1-3 years of recent medical claims experience or something related • Ability to communicate effectively and professionally with personnel, in both written and verbal form • Must possess a strong attention to detail and an interest in preventing errors • Ability to operate a personal computer (PC) and other office equipment (e.g., copy machine, fax machine, printer, calculator, etc.) as well as possess excellent keyboarding skills • Demonstrate ability to be dependable and professional • Demonstrate intrinsic initiative and time management skills • Must possess a strong commitment to teamwork and an ability to foster an inclusive culture of diversity by working well and collaborating with others as needed • Ability to accept feedback, learn, and adapt from guidance to be successful • Ability to adapt to consistently changing priorities and keep daily responsibilities on task • Ability to manage workload and ensure all tasks are completed within established timeframes • Must be willing and able to work possible mandatory overtime as needed based on business needs • Must be able to meet quality, productivity, and behavior expectations • Must possess basic reading and arithmetic skills (reading and math comprehension) • Customer service • Healthcare industry • Claims processing • Medical billing • Claims analysis Benefits • 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) Company Overview • At TEKsystems, they understand people.Every year they deploy over 80,000 IT professionals at 6,000 client sites across North America, It was founded in 1994, and is headquartered in Hanover, Maryland, USA, with a workforce of 10001+ employees. Its website is Apply tot his job Apply tot his job Apply tot his job Apply tot his job