Claims Technical Analyst

Description

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. Commercial Markets Claims Technical Analyst

Purpose:

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. Value Proposition/Selling Points (Market place advantages):
While the job is the same, to correct errors in RxClaim, the research and remediation steps can vary based on the error type and impacted claims. This offers a variety of research options and an opportunity to dig into the claim adjudication system functionality. Daily Responsibilities/

Job Description:

Perform standard queries to retrieve data for required analysis 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 Other duties as assigned Interaction level with Management/Team Members:
Interaction with team members will be daily. Leadership as needed, including dedicated meetings

Skills

Claims, Healthcare claims, Insurance claims, Claims analyst, Research

Top Skills Details

Claims,Healthcare claims,Insurance claims,Claims analyst,Research

Additional

Skills & Qualifications

Additional

Skills & Qualifications High school diploma Bachelors or associates preferred 4+ years of claims experience with emphasis on researching / auditing not processing or production Most recent position needs to be coming from a health insurance or PBM organization Not looking for someone coming from any other claims industry Claims software experience with RxClaims being preferred

Experience Level

Intermediate Level

Job Type & Location

This is a Contract position based out of Minneapolis, MN.

Pay and Benefits

The pay range for this position is $24.00 - $35.75/hr.

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.

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.

Final date to receive applications

This position is anticipated to close on Oct 23, 2026.

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,…