Remote Medical Claims Processor Jobs in Pewaukee, WI

We are seeking a Claims Analyst II to examine and process both paper and electronic healthcare claims. In this role, you will review, adjudicate, and process claims while ensuring compliance with policy guidelines, benefit plans, and established procedures. The ideal candidate will have prior claims processing experience, strong attention to detail, and the ability to manage production and quality standards in a fast-paced environment.

Important: Candidates must reside in the state of Wisconsin and be able to pick up equipment from the Menasha or Brookfield office.

Full-Time | 40 Hours per Week | Monday-Friday

• 2-4 years of healthcare claims processing experience
• Knowledge of medical terminology
• Understanding of CPT and ICD-9/ICD-10 coding
• Experience reviewing and adjudicating claims
• Strong attention to detail and analytical skills
• Ability to maintain confidentiality and meet productivity standards

• Process professional and facility claims for payment according to plan benefits, medical policies, and procedures.
• Review claims for completeness, accuracy, and compliance with billing standards.
• Determine whether claims should be paid, pended, denied, or returned.
• Investigate and resolve pending claims within established timelines.
• Process approved claim payments.
• Identify and appropriately adjudicate COB, Workers' Compensation, and Subrogation claims.
• Monitor claims processing systems and make corrections or adjustments as needed.
• Review claims for pricing and apply internal and external discounts when applicable.
• Process specialty claims including transplant, URN, and COB claims.
• Maintain department quality standards and turnaround time expectations.
• Document claim decisions and payment-related information accurately.
• Stay current on group contracts, provider agreements, discounts, authorizations, and utilization management policies.

This position offers flexibility through a remote or hybrid work model for qualified candidates residing in Wisconsin.

• Remote work available within Wisconsin
• Hybrid options available at Menasha or Brookfield offices
• Reliable internet connection required
• Training schedule: Monday-Friday, 8:00 AM-4:30 PM for the first 6 weeks (virtual training)
• Equipment pickup required from Menasha or Brookfield office

• Flexible remote and hybrid work options
• Stable full-time opportunity
• Comprehensive training program
• Collaborative team environment
• Opportunity to develop expertise in healthcare claims adjudication and administration

If you have healthcare claims processing experience and are looking for an opportunity to work with a team dedicated to quality and accuracy, we encourage you to apply today.

This is a Contract to Hire position based out of Brookfield, WI.

The pay range for this position is $19.25 - $19.25/hr.

Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors.

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)

This is a fully remote position.

This position is anticipated to close on Aug 31, 2026.

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’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.

San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.

Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.