Pharmacy Claims Analyst

Davita Inc.; Phoenix (AZ); Remote; USD 60,000 - 80,000; Full time

Job summary

A leading Pharmacy Benefit Management company seeks a Claims Analyst to conduct thorough analysis and remediation for pharmaceutical claims. The role demands expertise in researching and auditing claims with a strong preference for candidates familiar with RxClaims software. This fully remote contract position offers competitive pay and numerous benefits, reflecting the company's commitment to employee well-being.

Benefits

Medical, dental & vision

401(k) Retirement Plan

Life Insurance

Employee Assistance Program

Paid Time Off

Qualifications

• 2+ years of claims experience with emphasis on researching & auditing.
• Claims software experience, RxClaims preferred.

Responsibilities

• Perform client, member and pharmacy remediation analysis.
• Research and validate errors using analytics and data science techniques.
• Translate data into client-facing reports.

Skills

Researching

Auditing

Tools

RxClaims

Job description

life insurance, sick time, 401(k), retirement plan

United States, Arizona, Phoenix

*Join a large Pharmacy Benefit Management company based out of MN to help analyze and correct pharmaceutical claims!!*
*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.
*Main Position Details:*
*Job Title: *Claims Analyst
*Start Date: *7/14
*Pay:* $24.00/Hr
*Training:* 4-5 weeks in length Monday-Friday, 8:00am-4:30pm CST
*Schedule:* Pick your schedule, start time between 7:00am - 9:00am CST
*Location: *100% remote. All equipment is provided.
*Duration: *Contract. Set to finish at the end of the year.
*Qualifications:*

* 2+ years of claims experience with emphasis on researching & auditing (not processing or production).
* Claims software experience with RxClaims being preferred
*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 20, 2025.
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.

Helping all candidates find great careers is our goal. The information you provide here is secure and confidential.

We are now directing you to the original job posting. Please apply directly for this job at the employer’s website.