New

Healthcare Claims Policy Specialist

TEKsystems
$26.00 - $29.00 / hr
life insurance, sick time, 401(k), retirement plan
United States, Hawaii, Honolulu
Aug 05, 2025
* THIS POSITION IS FOR RESIDENTS OF OAHU ONLY * Location: Hybrid, Half the week in person in Honolulu, HI Pay: $27/hr + Position Summary: We are seeking a detail-oriented and experienced professional with experience in healthcare claims processing and policy development. The ideal candidate will play a key role in analyzing claims data, identifying trends, and drafting policies that ensure compliance with regulatory standards and improve operational efficiency. Key Responsibilities: * Analyze healthcare claims data to identify patterns, discrepancies, and opportunities for process improvement. * Develop, write, and revise internal policies and procedures related to claims processing, reimbursement, and compliance. * Collaborate with cross-functional teams including compliance, legal, and operations to ensure policies align with federal and state regulations. * Monitor changes in healthcare laws and regulations (e.g., CMS, HIPAA) and update policies accordingly. * Provide training and guidance to staff on new or revised policies and claims procedures. * Conduct audits and reviews of claims to ensure accuracy and adherence to policy. * Serve as a subject matter expert on claims adjudication and policy interpretation. Qualifications: * Bachelor's degree in Healthcare Administration, Public Health, Business, or related field (Master's preferred). * 3+ years of experience in healthcare claims processing and policy writing. * Strong understanding of healthcare reimbursement methodologies (e.g., Medicare, Medicaid, commercial insurance). * Excellent written and verbal communication skills. * Proficiency in data analysis tools and claims management systems. * Ability to interpret complex regulations and translate them into actionable policies. Preferred Skills: * Experience with regulatory compliance and healthcare audits. * Familiarity with EHR systems and claims platforms. * Certification in healthcare compliance (e.g., CHC, CPC) is a plus. Pay and Benefits The pay range for this position is $26.00 - $29.00/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 Type This is a fully onsite position in Honolulu,HI. Application Deadline This position is anticipated to close on Aug 18, 2025. 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.