Medical Claims Analyst

Davita Inc.; Minnesota City (MN); Remote; USD 10,000 - 60,000; Full time

Job summary

A leading company is hiring a fully remote Medical Claims Analyst responsible for analyzing and correcting medical claims. The position requires claims experience with an emphasis on research and auditing, as well as claims software experience. The role offers comprehensive benefits including health insurance and a 401(k) plan.

Benefits

Medical, dental & vision insurance

401(k) Retirement Plan

Short and long-term disability

Health Spending Account (HSA)

Employee Assistance Program

Qualifications

• 2+ years of claims experience required, focusing on auditing.
• Experience with claims software, preferably RxClaims.
• Understanding of medical terminology including copays and deductibles.

Responsibilities

• Analyze and correct medical claims using RxClaim processing system.
• Conduct data validation and claims monitoring.
• Translate data into client-facing reports.

Skills

Researching

Auditing

Analytical skills

Attention to detail

Tools

RxClaims

Job description

*TEKsystems is hiring for a fully remote Medical Claims Analyst for a PBM to help analyze and correct medical claims!!*
*Start Date: *July 14th
*MUST HAVES:*
2+ years of claims experience with emphasis on researching / auditing not processing or production
Claims software experience with RxClaims being preferred
*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.
*Shift:*
4-5 weeks of training Monday-Friday, 8am-4:30pm CST; after training you can pick your start time of 7am-9am CST
*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 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.