Complex Medical Claims Specialist

TEKsystems • Chicago, IL • 13h ago

Complex Medical Claims Analyst

Contract | Remote | Intermediate Level

The Claims Analyst is responsible for managing a portfolio of complex commercial insurance claims from initial investigation through resolution. This role requires strong analytical skills, sound judgment, and the ability to collaborate effectively with internal partners, external counsel, insureds, and claimants. The ideal candidate has experience handling commercial claims-such as general liability, auto liability, or professional liability-and excels in a fast-paced, detail-driven environment.

Key Responsibilities

Claim Management & Investigation

Manage a caseload of complex commercial claims with significant exposure, ensuring each claim is handled efficiently and in accordance with company guidelines.

Conduct thorough investigations by gathering statements, reviewing contracts and documentation, interviewing involved parties, and coordinating with experts as needed.

Verify policy coverage, interpret policy language, and establish accurate and timely reserves.

Identify compensability, liability, and damages to determine claim validity and develop effective strategies for resolution.

Customer Service & Communication

Deliver exceptional customer service by maintaining proactive communication with insureds, claimants, attorneys, and internal stakeholders.

Provide timely updates, respond to inquiries promptly, and ensure all parties remain informed throughout the claim lifecycle.

Resolution & Negotiation

Develop and execute strategic claim resolution plans, collaborating with coverage experts, legal partners, and internal teams.

Negotiate settlements, manage complex litigation when needed, and authorize payments within designated authority levels.

Identify potential subrogation or fraud opportunities and refer to appropriate internal departments.

Compliance & Documentation

Ensure claims are handled in alignment with regulatory requirements and internal protocols.

Maintain accurate, well-documented claim files that meet quality and compliance standards.

Prepare summaries for leadership regarding high-risk claims or significant exposures.

Financial Management

Establish and manage claim budgets, oversee expenses, and ensure resources are used efficiently.

Support timely and accurate billing, expense approval, and closure of claims.

Required Qualifications

Minimum 1-3 years of commercial claims experience must have medical malpractice experience

Strong understanding of policy interpretation, liability assessment, and claim negotiation.

Excellent communication, analytical, and organizational skills.

Experience Level

Intermediate Level

Job Type & Location

This is a Contract position based out of Chicago, IL.

Pay and Benefits

The pay range for this position is $24.00 - $28.84/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 remote position.

Application Deadline

This position is anticipated to close on Mar 24, 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.

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