Job Description
Job Summary
We are seeking an experienced Claims Examiner to join our team. In this role, you will be responsible for researching, reviewing, correcting, and resolving pended medical claims while ensuring compliance with company policies, procedures, and regulatory guidelines. The ideal candidate will have prior claims examination experience and a strong understanding of medical claims processing, claims adjudication, and denial management.
Key Responsibilities
+ Research, review, and resolve pended medical claims in a timely and accurate manner.
+ Determine claim payment eligibility based on established policies, procedures, and benefit guidelines.
+ Analyze and adjudicate medical claims while ensuring accuracy and compliance.
+ Review audit reports and take appropriate corrective actions as needed.
+ Investigate and respond to claim discrepancies, denials, and processing issues.
+ Maintain correspondence related to required ...
We are seeking an experienced Claims Examiner to join our team. In this role, you will be responsible for researching, reviewing, correcting, and resolving pended medical claims while ensuring compliance with company policies, procedures, and regulatory guidelines. The ideal candidate will have prior claims examination experience and a strong understanding of medical claims processing, claims adjudication, and denial management.
Key Responsibilities
+ Research, review, and resolve pended medical claims in a timely and accurate manner.
+ Determine claim payment eligibility based on established policies, procedures, and benefit guidelines.
+ Analyze and adjudicate medical claims while ensuring accuracy and compliance.
+ Review audit reports and take appropriate corrective actions as needed.
+ Investigate and respond to claim discrepancies, denials, and processing issues.
+ Maintain correspondence related to required ...
Ready to Apply?
Submit your application today and join our talented team at TEKsystems.
Submit ApplicationJob Details
- Location Santa Barbara, CA
- Job Type Full-time
- Category other-general
- Posted Date June 27, 2026
- Application Deadline July 02, 2026