Remote Claims Analyst

Job Summary

A company is looking for a Claims Analyst to join their remote team.

Key Responsibilities

• Analyze pharmacy claims for accuracy and compliance before payment
• Assist in identifying and recovering overpayments or pricing errors
• Prepare documentation and develop recurring and ad-hoc data reports for stakeholders

Required Qualifications

• Bachelor's or Master's degree in Business, Healthcare, Audit, Insurance, or related field, or equivalent experience
• Minimum of 2 years in claims processing, analysis, auditing, or PBM operations; Medicaid experience preferred
• Strong working knowledge of pharmacy claims and adjudication systems
• Experience in preparing documentation and training materials
• National pharmacy technician certification and 2+ years of claims auditing experience preferred