[Hiring] Sr. Claims Analyst @TEKsystems

Role Description

Our client is building a project team to support the coupon process within their claims system. They are currently developing automation that will allow uploaded coupons to automatically adjust claims with accurate billing. However, at present, a claim may be initiated before a coupon is received, resulting in invoices that do not reflect the discount.

• Review full claims and manually apply coupons to ensure accurate billing.
• Run queries and analyze data using Excel.
• Recalculate pricing and adjust invoices based on coupon application.
• Perform hands-on, manual work involving Excel formulas and data manipulation.
• Ensure final invoices reflect correct pricing after coupon adjustments.

Qualifications

• High School Diploma / GED required
• Associate or Bachelor degree strongly preferred or equivalent experience
• Minimum of 5 years of health insurance or PBM claims experience.
• Must show progression in career to someone who has done a deep level of research within the claims system. They cannot be someone who has allowed the adjudication system to do most of the claim.
• 3+ years of using Excel daily to run queries, formulas, VLOOKUP's.

Requirements

• Claims
• Research
• Math
• Rx Claims
• PBM
• Health Insurance
• Excel
• Formulas
• Adjudication

Benefits

• 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.

Application Deadline

This position is anticipated to close on Oct 15, 2025.