TEKsystems
Remote Claims Analyst
TEKsystems, Minneapolis, Minnesota, United States, 55400
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. The more research and auditing experience they have the more they will succeed in this role. The understanding of medical terminology (Copays, deductibles, and benefit plans) will help them in this role.
Skills:
Claims, RxClaims, Pharmacy benefits, Health insurance, Claims Analyst, Audit, support, analysis, workflow, claim, Healthcare, Medical Terminology
Top Skills Details:
Claims, RxClaims, Pharmacy benefits, Health insurance,Claims Analyst, Audit, support, analysis
Additional Skills & Qualifications:
High school diploma
Bachelors or associates preferred
2+ years of claims experience with emphasis on researching / auditing not processing or production
Claims software experience with RxClaims being preferred
Experience Level:
Intermediate Level
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 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.
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. The more research and auditing experience they have the more they will succeed in this role. The understanding of medical terminology (Copays, deductibles, and benefit plans) will help them in this role.
Skills:
Claims, RxClaims, Pharmacy benefits, Health insurance, Claims Analyst, Audit, support, analysis, workflow, claim, Healthcare, Medical Terminology
Top Skills Details:
Claims, RxClaims, Pharmacy benefits, Health insurance,Claims Analyst, Audit, support, analysis
Additional Skills & Qualifications:
High school diploma
Bachelors or associates preferred
2+ years of claims experience with emphasis on researching / auditing not processing or production
Claims software experience with RxClaims being preferred
Experience Level:
Intermediate Level
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 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.