New

Claims Examiner- Northridge, CA

TEKsystems
$25.00 / hr
life insurance, sick time, 401(k), retirement plan
United States, California, Northridge
Aug 16, 2025
Job Title: Claims Examiner Location: 8510 Balboa Blvd Ste 275, Northridge, CA, 91325-5809, USA Start Date: September 2, 2025 Interview Date: August 22, 2025 About the Role We are seeking a detail-oriented and experienced Claims Examiner to join our team in Northridge, CA. This role focuses on auditing and compliance within claims processing, including benefit analysis, system design, and managing special projects related to claim denials and auto-adjudication. You'll work under limited supervision and collaborate with management to identify risks, reduce adjudication errors, and improve operational efficiency. Key Responsibilities * Conduct audits and compliance reviews of HMO and Medicare claims. * Analyze benefit structures and system configurations (EZCap or similar). * Manage special projects and track outcomes for reporting to leadership. * Investigate and resolve claim denials and resubmissions. * Collaborate with cross-functional teams to improve claims processes. * Ensure documentation and workflow meet regulatory and internal standards. * Must-Have Skills * HMO Claims Processing * Claim Denials and Resubmissions * EZCap System Experience * Medicare Claims Knowledge * Claims Audits and Compliance * Nice-to-Have Skills * CPT Code Familiarity * Excel Proficiency * Understanding of Medicare Guidelines Qualifications * Minimum 5 years of experience in claims processing and system configuration. * Strong organizational, communication, and analytical skills. * Ability to work independently and prioritize tasks effectively. * Proficiency in MS Office Suite (Excel, Access, PowerPoint, Word). * Experience with regulatory agency requirements preferred. Work Environment You'll be working on-site in a collaborative and fast-paced environment. 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 Northridge,CA 91324. Application Deadline This position is anticipated to close on Aug 28, 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.