Claims Analyst- Remote Pharmacy Benefits

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

Job summary

A well-known technology services provider is seeking a Claims Analyst to support claims analysis and auditing processes. In this fully remote role, you will leverage your research skills and medical terminology knowledge to enhance claims accuracy and financial validation. Ideal candidates have 2+ years of relevant experience in claims auditing, ensuring thoroughness in addressing issues and discrepancies. The role offers a competitive hourly pay rate of $24.00 with additional benefits.

Benefits

Medical, dental & vision

401(k) Retirement Plan

Life Insurance

Short and long-term disability

Health Spending Account (HSA)

Transportation benefits

Employee Assistance Program

Time Off/Leave (PTO, Vacation or Sick Leave)

Qualifications

• 2+ years of claims experience with emphasis on researching/auditing.
• Experience necessary in claims software, preferably RxClaims.
• Strong attention to detail and analytical skills are required.

Responsibilities

• Perform client and pharmacy remediation analysis based on claims errors.
• Monitor claims and validate data for discrepancies.
• Translate data into client-facing reports.

Skills

Claims

RxClaims

Pharmacy benefits

Health insurance

Claims Analyst

Audit

Support

Analysis

Workflow

Medical Terminology

Education

High school diploma

Bachelors or associates preferred

Tools

Claims software

Job description

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

Experience Level

Claims software experience with RxClaims being preferred

Intermediate Level

Pay And Benefits

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

Application Deadline

This position is anticipated to close on Jun 13, 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.