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Medical Claims Examiner
Medical Claims Examiner-January 2024
Chula Vista
Jan 2, 2026
About Medical Claims Examiner

  Description:

  1.Maintain multiple groups of claims in the queue

  Process CMS-1500 claims

  Process UB-04 claims

  Process high dollar claims

  Process JAA / BlueCard claims

  Interpret individual group SPD’s and apply benefits appropriately

  Zero dollar adjustments

  Maintain Provider Assignment, COB, Medi-Cal, CAS Status 8 reports

  Review/create/process FOGBUGZ cases

  Access Anthem Blue Cross website for inquiries and JAA / BlueCard claims processing

  Batch/Scan correspondence

  Access WIKI for Advantek policies and procedures

  Access email for department communication

  Keep track of and work spreadsheets for special projects

  Maintain confidentiality of sensitive information.

  Maintain effective communication with team members and managers.

  Maintain Claim Inventory turnaround time and volume within acceptable levels

  In the spirit of teamwork, employees are expected to follow any other job-related instructions and to perform any other job-related duties as requested.

  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.

  We are an equal opportunity employers and will consider all applications without regard to race, genetic information, sex, age, color, religion, national origin, veteran status, disability or any other characteristic protected by law. To view the EEO is the law poster click here. Applicants with disabilities that require an accommodation or assistance a position, please call 888-472-3411 or email [email protected]. This is a dedicated line designed exclusively to assist job seekers whose disability prevents them from being able to apply online. Messages left for other purposes will not receive a response.

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