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Job Description

Insight Global is seeking a Claims Technical Analyst for one of our large PBM clients. This role is responsible for performing basic to 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. You will be tasked with correcting errors in RxClaim, the research and remediation steps can vary based on the error type and impacted claims. This offers a variety of research options and an opportunity to dig into the claim adjudication system functionality.

Some of the day-to-day responsibilities of this role includes the following:

-Perform standard queries to retrieve data for required analysis

-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

-Other duties as assigned

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to [email protected] learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.

Skills and Requirements

-Experience working with claims data or systems

-Strong analytical, problem solving and decision-making skills

-Strong verbal and written communication skills

-Ability to work in a fast-paced, collaborative team environment -RxClaim experience

-Analytical background