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# Claims Technical Analyst

- **Company:** CareerCircle
- **Location:** Saint Paul, MN, United States (Remote available)
- **Experience:** Experienced
- **Salary:** $49,920.0 - $74,360.0
- **Contract:** Temporary contract
- **Skills:** Artificial Intelligence, Data Analysis, Data Validation
- **Published:** October 13, 2026
- **Apply:** https://www.careercircle.com/jobs/all/all/usa/mn/saint-paul/e5b38e11-0b5c-4454-8a5e-f06cc528e9df

## About the Role

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.

## Description

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.
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