Claims Operations Specialist

TEKsystems is seeking a Claims Specialist to support a leading healthcare payer organization in Hawaii. This role focuses on supporting end-to-end claims processing operations, ensuring accurate and timely adjudication, and contributing to process improvements across workflows. This is a great opportunity for someone with strong healthcare claims experience who wants to play a key role in improving operational efficiency and service quality. This person should be in Oahu and able to work hybrid. If you are interested, please apply and one of our recruiters will get back to you!
Responsibilities

+ Support daily claims processing activities including intake, adjudication, adjustments, and issue resolution

+ Ensure claims are processed accurately, efficiently, and in compliance with regulatory and internal guidelines

+ Monitor claims-related metrics such as turnaround time, accuracy, and backlog

+ Assist with investigating and resolving complex or e...

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