Remote Claims Analyst

Davita Inc.; Milwaukee (WI); Remote; USD 60,000 - 80,000; Full time

Job summary

A leading provider of business and technology services is seeking a Claims Analyst responsible for conducting thorough analysis and remediation for client claims. This remote opportunity involves using analytics and data science techniques to address claims issues, alongside providing reports that highlight financial impacts. Ideal candidates should possess a strong background in claims research and auditing, as well as knowledge of medical terminology. Comprehensive benefits are available for eligible employees.

Benefits

Medical, dental & vision

401(k) Retirement Plan

Life Insurance

Short and long-term disability

Health Spending Account (HSA)

Transportation benefits

Employee Assistance Program

Paid Time Off / Leave

Qualifications

• 2+ years of claims experience with emphasis on researching/auditing.
• Knowledge of medical terminology including copays and benefit plans.

Responsibilities

• Perform client, member and pharmacy remediation analysis.
• Research and analyze claims, translating data into client-facing reports.

Skills

Researching

Auditing

Analytical Skills

Education

High school diploma

Bachelor's or associates degree

Tools

Claims software (RxClaims preferred)

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.
*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.