Medical Claims Examiner
4 weeks ago
Job Summary
We are seeking a skilled Medical Claims Processor to join our team at TEKsystems. As a Medical Claims Processor, you will be 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.
Key Responsibilities
- 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;
- Understand medical terminology, including copays, deductibles, and benefit plans, to effectively perform job duties.
Requirements
- Bachelor's or associate's degree preferred;
- 2+ years of claims experience with emphasis on researching/auditing, not processing or production;
- Claims software experience with RxClaims being preferred.
About TEKsystems
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.
Equal Opportunity Employer
TEKsystems 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.
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