New

Claims Specialist

TEKsystems
$26.00 / hr
life insurance, sick time, 401(k), retirement plan
United States, California, Canoga Park
Apr 25, 2026
Claims Specialist Location: West Hills, CA 91304 Workplace Type: OnSite Job Type: Contract Schedule: Monday-Friday \| 8:30am-5:00pm Pay: $26/hr Overview We're hiring a Claims Specialist to support healthcare claims compliance and adjudication operations within a highvolume environment. This role focuses on claims review, authorization validation, denials processing, and compliance auditing, ensuring claims are processed accurately and in alignment with HMO and Medicare guidelines. If you have strong experience with EZCAP, HMO claims, and authorization workflows, this is a highimpact role where your expertise will matter. What You'll Be Doing * Review institutional and professional claims to validate authorization requirements and payer contracts * Determine whether existing authorizations can be used to process claims and update EZCAP accordingly * Prepare claims for administrative denial when appropriate and route back to examiners * Perform case followup with Medical Directors and update case status (approx. 216 active cases) * Review claims for sensitive services and special cases, including Guardant claims, validating authorization via REA * Track, analyze, and document claim outcomes, identifying trends and potential compliance risks * Support claims audits, resubmissions, and special projects tied to operational and system improvements MustHave Skills * Strong experience with HMO Claims * Experience* in Claim Denials* and authorization review * Handson experience using EZCAP or similar claims systems * Knowledge of Medicare Claims and payer guidelines * Solid understanding of claims workflows and adjudication standards NiceToHave Skills * Knowledge of CPT Codes * Excel proficiency for tracking, reporting, or auditing * Familiarity with Medicare Guidelines * Experience in claims audits or compliance review Experience & Qualifications * 5+ years of experience in claims processing, claims analysis, or claims compliance * Experience with system configuration or workflow optimization preferred * Ability to collaborate with leadership and crossfunctional teams on process improvements * Strong analytical skills with attention to detail in highvolume claims environments Why Join Us You'll be joining a team where claims accuracy and compliance directly impact operational success. This role offers exposure to complex claims scenarios, auditing processes, and systemdriven workflows while supporting continuous improvement initiatives. This is a Stable Contract Opportunity with longterm potential based on performance and business needs. Job Type & LocationThis is a Contract position based out of Canoga Park, CA 91304. Pay and BenefitsThe pay range for this position is $26.00 - $26.00/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 TypeThis is a fully onsite position in Canoga Park,CA 91304. Application DeadlineThis position is anticipated to close on May 8, 2026. 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.