Claims Technical Analyst

TEKsystems; United States; Remote; USD 27,000 - 39,000; Full time

Benefits offered by this job

Medical, dental & vision

401(k) Retirement Plan

Short and long-term disability

Job summary

TEKsystems is seeking an experienced Contract Claims Technical Analyst to perform basic to intermediate remediation analysis of RxClaim errors, along with claims monitoring and data validation activities. You will research and analyze information, isolate impacted claims, reprocess where needed, and translate findings into client reports.

The role emphasizes thorough analytics, with 4+ years in health insurance claims and RxClaims experience preferred.

Qualifications

• 4+ years of claims experience with emphasis on researching / auditing not processing or production.
• Most recent position needs to be coming from a health insurance or PBM organization.
• Not looking for someone coming from any other claims industry.
• Claims software experience with RxClaims being preferred.

Responsibilities

• Perform standard queries to retrieve data for required analysis.
• Research and analyze information using analytics and data science to validate errors, isolate claims, reprocess claims, and determine financial impact.
• Translate data into usable client facing reports; other duties as assigned.

Skills

Claims

Healthcare claims

Insurance claims

Claims analyst

Research

Tools

RxClaims

Job description

Description

Job 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.

Commercial Markets Claims Technical Analyst

Purpose

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.

Value Proposition/Selling Points (Market place advantages)

While the job is the same, to correct errors in RxClaim, the research and remediation steps can vary based on the error type and impacted claims. This offers a variety of research options and an opportunity to dig into the claim adjudication system functionality.

Daily Responsibilities/Job Description

Perform standard queries to retrieve data for required analysis

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

Other duties as assigned

Interaction level with Management/Team Members

Interaction with team members will be daily. Leadership as needed, including dedicated meetings

Skills

Claims, Healthcare claims, Insurance claims, Claims analyst, Research

Top Skills Details

Claims,Healthcare claims,Insurance claims,Claims analyst,Research

Additional Skills & Qualifications

Additional Skills & Qualifications

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

Most recent position needs to be coming from a health insurance or PBM organization

Not looking for someone coming from any other claims industry

Claims software experience with RxClaims being preferred

Experience Level

Intermediate Level

Job Type & Location

This is a Contract position based out of Saint Paul, MN.

Pay and Benefits

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

Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors.

Eligibility requirements apply to some benefits and may depend on your jobclassification and length of employment. Benefits are subject to change and may besubject to specific elections, plan, or program terms. If eligible, the benefitsavailable for this temporary role may include the following:Medical, dental & visionCritical Illness, Accident, and Hospital401(k) Retirement Plan Pre-tax and Roth post-tax contributions availableLife Insurance (Voluntary Life & AD&D for the employee and dependents)Short and long-term disabilityHealth Spending Account (HSA)Transportation benefitsEmployee Assistance ProgramTime Off/Leave (PTO, Vacation or Sick Leave)

Job Type & Location

This is a Contract position based out of Saint Paul, MN.

Application Deadline

This position is anticipated to close on Nov 2, 2026.

Workplace Type

This is a fully remote position.

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

Were 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. Were 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. Were strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. Were 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.

San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.

Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.