Medical Claims Analyst

About the role

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 vary based on the issue, requiring thorough and detailed work. The analyst will employ 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, translating data into usable client‑facing reports.

Responsibilities

• Perform client, member and pharmacy remediation analysis
• Conduct claims monitoring and data validation
• Research and validate errors using analytics and data‑science techniques
• Isolate impacted claims and reprocess them
• Determine financial impact to members, health plans and/or pharmacies
• Translate data into client‑facing reports

Requirements

• 2+ years of claims experience with emphasis on researching/auditing (not processing/production)
• Experience resolving pharmacy claims preferred
• Understanding of medical terminology (copays, deductibles, benefit plans)

Skills

• Strong research and auditing abilities
• Analytics and data‑science techniques
• Detail‑oriented and thorough
• Ability to isolate and reprocess claims
• Financial impact analysis
• Reporting and translation of data into usable formats

Pay

The pay range for this position is $24.00 – $24.00 per hour (fixed rate).

Benefits

• Medical, dental & vision
• Critical Illness, Accident, and Hospital coverage
• 401(k) Retirement Plan (pre‑tax and Roth post‑tax contributions)
• Life Insurance (Voluntary Life & AD&D for 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)

Schedule

Initial training: 4‑5 weeks, Monday‑Friday, 8 am‑4:30 pm CST. After training, you can choose a start time between 7 am‑9 am CST.

Position: Contract, based out of Minneapolis, MN (fully remote). Application anticipated to close Oct 18, 2026.