[Hiring] Claims Technical Analyst @TEKsystems

Role 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.
• Perform standard queries to retrieve data for required analysis.
• Other duties as assigned.

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.
• Claims software experience with RxClaims being preferred.

Requirements

• Claims, Healthcare claims, Insurance claims, Claims analyst, Research.

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).

Company Description

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.