Claims Technical Analyst

Job Description

Job Description

Claims Technical Analyst

Location: 100% Remote

Schedule: Full-Time, Monday-Friday

We are seeking an experienced Claims Technical Analyst to support claims research, auditing, remediation, and data validation activities within a healthcare claims environment. This role is ideal for someone who enjoys investigating complex claim issues, analyzing data, and identifying solutions that impact members, health plans, and pharmacies.

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.

• 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

• 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

• 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

• 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.

#centralpriority26

This is a Contract position based out of Saint Paul, MN.

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)

This is a Contract position based out of Saint Paul, MN.

This position is anticipated to close on Oct 26, 2026.

This is a fully remote position.

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, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

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.

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.

San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.

Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

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.