Claims Technical Analyst

Research Scheduling Operations Leadership Adjudication Managed Care Data Analysis Detail Oriented Problem Solving Data Validation Claims Resolution Business Valuation Technical Analysis Claims Investigations Full Stack Development Business Transformation Copayment Collection And Processing, * Research and analyze claim issues to identify root causes and impacted claims

• Perform data validation and claims monitoring activities
• Execute standard queries and review data to support investigations
• Reprocess claims and determine financial impacts to members, health plans, and pharmacies
• Develop and deliver reports summarizing findings and remediation efforts
• Audit claim transactions for accuracy and compliance
• Collaborate with team members and leadership to resolve claim-related issues
• Maintain documentation and support ongoing process improvements, * Opportunity to perform investigative and analytical claims work rather than high-volume claims processing
• Exposure to complex claims remediation and audit activities
• Collaborative team environment with ongoing training and support
• Long-term contract opportunity with a nationally recognized healthcare organization

If you have a background in healthcare claims analysis and enjoy solving complex claim issues through research and data analysis, we’d love to hear from you., 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. Related Jobs Claims Technical Analyst TEKsystems

Saint Paul, MN*Remote

Auditing Research Scheduling Operations Leadership Adjudication Managed Care Data Analysis Detail Oriented Problem Solving Data Validation Claims Resolution Business Valuation Technical Analysis Claims Investigations Full Stack Development Business Transformation Copayment Collection And Processing +0 Claims Technical Analyst TEKsystems

Minneapolis, MN*Remote

Auditing Research Operations Leadership Management Adjudication Data Science Data Validation Selling Techniques Value Propositions Business Valuation Technical Analysis Medical Terminology Full Stack Development Business Transformation Copayment Collection And Processing +0 Login | JoinContact

The ideal candidate will have a strong background in healthcare or pharmacy claims, exceptional attention to detail, and experience researching and auditing claim discrepancies rather than solely processing claims., * 4+ years of healthcare claims experience

• Strong experience in claims research, auditing, or remediation
• Experience working for a health insurance, managed care, or PBM organization
• Knowledge of healthcare terminology, including copays, deductibles, and benefit plans
• Strong analytical, problem-solving, and investigative skills
• Ability to work independently in a remote environment, * Associate’s or Bachelor’s degree
• Experience with claims adjudication systems
• Pharmacy claims or PBM experience
• Experience using RxClaims or similar claims platforms

Work Environment

• Fully remote position
• Quiet home office or dedicated workspace required
• Structured training program provided
• Core business hours of 9:00 AM - 3:00 PM CST with scheduling flexibility outside of those hours, 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.

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., 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.