We are seeking a detail-oriented professional to manage D-SNP pended claims and ensure compliance with regulatory guidelines. This role involves:

• Researching, correcting, and responding to all D-SNP pended claims in a timely manner.
• Reviewing audit reports and determining claim payment eligibility in accordance with policies and procedures.
• Maintaining accurate documentation for procedures, medical codes (CPT, HCFA), and correspondence.
• Reviewing, pricing, and releasing claims for assigned claim types (paper and electronic).
• Monitoring and reviewing manual reports that suspend for D-SNP claim review.
• Staying current on all D-SNP policies and contributing to departmental improvement projects.
• Maintaining a daily activity log and assisting with claims processing.
• Performing other duties and projects as assigned.

• Claims processing
• Healthcare knowledge

• Experience with QNXT
• Strong knowledge of the D-SNP program
• Expertise in dual-eligible claims processing (Medi-Cal and Medicare D-SNP)
• Prior experience in a high-volume production environment
• Excellent oral and written communication skills
• Strong attention to detail
• Medical terminology and/or coding experience (highly desirable)

Entry Level

This is a Contract position based out of Santa Barbara, CA.

The pay range for this position is $24.00 - $27.00/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)

This is a hybrid position in Santa Barbara,CA.

This position is anticipated to close on Jan 12, 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.