Pharmacy Claims Analyst

About the Role We are seeking a detail-oriented Claims Technical Analyst to support a leading healthcare and pharmacy benefits organization. This position focuses on researching, auditing, and remediating pharmacy claims impacted by system configuration errors within the RxClaim platform.

Location:

Remote (U.S.)

Schedule:

Full-Time | Core Hours 9:00 AM-3:00 PM CST (Flexible 8-Hour Shift)
Training

Hours:

8:00 AM-4:30 PM CSTKey Responsibilities Perform standard queries and data retrieval activities to support claims analysis.

Investigate claims processing errors and identify impacted members, pharmacies, and health plans.

Conduct remediation analysis related to errors within the RxClaim system.

Validate claim issues, isolate affected claims, and support claim reprocessing activities.

Analyze financial impacts related to claim errors and adjustments.

Review and monitor claims data to ensure accuracy and compliance.

Translate complex data findings into clear, client-facing reports and documentation.

Research claim adjudication outcomes and identify root causes of processing discrepancies.

Support auditing, issue tracking, reporting, and data validation initiatives.

Collaborate with team members and leadership to resolve claims-related issues.

Participate in meetings, training activities, and ongoing process improvement initiatives.

Perform additional duties and analytical projects as assigned.

Required Qualifications High School Diploma or GED required.

Minimum of 4+ years of healthcare or PBM claims experience with a strong emphasis on:

Claims research

Claims auditing

Claims analysis

Claims remediation

Recent experience working for a:

Health insurance company

Pharmacy Benefit Manager (PBM)
Strong understanding of:

Copays Deductibles Benefit  plans

Claim adjudication processes

Experience conducting detailed research and root-cause analysis.

Strong analytical and problem-solving abilities.

Ability to work independently while managing multiple priorities.

Excellent attention to detail and accuracy.

Strong written and verbal communication skills.

Work Environment
100% remote position.

Quiet home office or dedicated workspace required.

Flexible work schedule after training.

Daily collaboration with team members and leadership.

Structured training and strong team support.

Why Join Us?

Opportunity to work with a leading healthcare and pharmacy benefits organization.

Challenging analytical work that offers variety and continuous learning.

Hands-on experience with pharmacy claims adjudication and remediation.

Fully remote work environment.

Collaborative team culture with comprehensive onboarding and training.

Exposure to complex claims systems and healthcare operations.

If you have a passion for claims research, auditing, data analysis, and problem-solving within the healthcare or PBM industry, we encourage you to apply today.

Job Type & Location This is a Contract position based out of Saint Paul, 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)
Job Type & Location This is a Contract position based out of Saint Paul, MN.Final date to receive applications

This position is anticipated to close on Oct 26, 2026.Workplace Type This is a fully remote position.

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…