Claims Analyst- Remote Pharmacy Benefits

Lensa; Minneapolis (MN); Remote; USD 80,000 - 100,000; Full time

Job summary

A leading company in healthcare claims management seeks a Claims Analyst to join their remote team. The ideal candidate will analyze and validate claims data, ensuring accuracy and compliance. This role requires strong analysis skills in claims processing and a solid understanding of medical terminology.

Benefits

Medical, dental & vision insurance

401(k) Retirement Plan

Life Insurance (Voluntary Life & AD&D)

Short and long-term disability

Health Spending Account (HSA)

Transportation benefits

PTO, Vacation or Sick Leave

Qualifications

• 2+ years of claims experience, focus on research/auditing.
• Understanding of medical terminology preferred.
• Full-time availability for remote work.

Responsibilities

• Perform client and pharmacy remediation analysis.
• Research and validate errors in the RxClaim system.
• Create client-facing reports based on data analysis.

Skills

Claims

RxClaims

Pharmacy benefits

Health insurance

Claims Analyst

Audit

Support

Analysis

Workflow

Healthcare

Medical Terminology

Education

High school diploma

Bachelors or associates preferred

Tools

RxClaims

Job description

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Description

This role is responsible for performing basic and intermediate level client, member and pharmacy remediation analysis caused by errors coded into the RxClaim processing system, along with claims monitoring and data validation activities. The research and remediation steps can vary based on the issue so this person must be very thorough and detailed. Research and analyze information by employing analytics and data science techniques to research and validate errors, isolate impacted claims, reprocess claims, and determine financial impact to members, health plans and/or pharmacies; translate data into usable client facing reports. The more research and auditing experience they have the more they will succeed in this role. The understanding of medical terminology (Copays, deductibles, and benefit plans) will help them in this role.

Skills

Claims, RxClaims, Pharmacy benefits, Health insurance, Claims Analyst, Audit, support, analysis, workflow, claim, Healthcare, Medical Terminology

Top Skills Details

Claims, RxClaims, Pharmacy benefits, Health insurance, Claims Analyst, Audit,Support, analysis

Additional Skills & Qualifications

High school diploma

Bachelors or associates preferred

2+ years of claims experience with emphasis on researching / auditing not processing or production

Claims Software Experience With RxClaims Being Preferred

Experience Level

Intermediate Level

Pay and Benefits

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

Requirements

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 Jun 19, 2025.

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.

If you have questions about this posting, please contact [e-mail]

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Finance and Sales

• Industries

  IT Services and IT Consulting

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