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Pharmacy Claims Analyst

$24 - $35.75 per hour

TEKsystems

About the RoleWe 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 ResponsibilitiesPerform 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 QualificationsHigh School Diploma or GED required.Minimum of 4+ years of healthcare or PBM claims experience with a strong emphasis on:Claims researchClaims auditingClaims analysisClaims remediationRecent experience working for a:Health insurance companyPharmacy Benefit Manager (PBM)Strong understanding of:CopaysDeductiblesBenefit plansClaim adjudication processesExperience 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 Environment100% 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 & LocationThis is a Contract position based out of Saint Paul, MN.Pay and BenefitsThe 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 & LocationThis is a Contract position based out of Saint Paul, MN.Application DeadlineThis position is anticipated to close on Oct 28, 2026.Workplace TypeThis is a fully remote position.About TEKsystemsWe'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.About TEKsystems and TEKsystems Global Services 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.Job SummaryJob number: JP-006351389Profession: Other

Vacancy posted 2 days ago
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