Remote Claims Analyst

TEKsystems; Milwaukee (WI); Remote; USD 60,000 - 80,000; Full time

Job summary

TEKsystems is seeking a Remote Claims Analyst to perform client and pharmacy remediation analysis. This role emphasizes thorough research and validation of claims, ensuring accurate financial impact assessment. Ideal candidates will have claims experience and a grasp of medical terminology, contributing to essential data analysis efforts.

Benefits

Medical, dental & vision

401(k) Retirement Plan

Life Insurance

Short and long-term disability

Employee Assistance Program

Time Off/Leave

Qualifications

• 2+ years of claims experience focused on researching and auditing.
• Knowledge of medical terminology essential.
• Experience with claims software preferred.

Responsibilities

• Perform client, member, and pharmacy remediation analysis.
• Research errors coded in RxClaim processing system.
• Translate data into client-facing reports.

Skills

Attention to detail

Analytical skills

Education

High school diploma

Bachelors or associates preferred

Tools

RxClaims software

Job description

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• 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.
  
  
  

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.
  
  
  

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
• Knowledge of medical terminology (Copays, deductibles, and benefit plans)
  
  
  

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.

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.

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Finance and Sales

• Industries

  IT Services and IT Consulting

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