New

Remote Revenue Cycle Claims Analyst

TEKsystems
$30.00 - $35.00 / hr
life insurance, sick time, 401(k), retirement plan
United States, Massachusetts, Boston
Aug 05, 2025
Job Summary: We are seeking a detail-oriented and analytical Revenue Cycle Claims Analyst to join our remote team. Under the direction of the Revenue Cycle Supervisor - Pharmacy, this role is responsible for pursuing insurance companies for payment or underpayment of services rendered, ensuring accurate reimbursement through correct contract terms, billing practices, and compliance with state and federal guidelines. The ideal candidate will possess strong problem-solving skills, a deep understanding of pharmacy billing, and the ability to audit and reconcile complex accounts. Key Responsibilities: * Research and resolve rejected drug claims; prepare claims that fail payer edits. * Serve as a subject matter expert on strategic provider relationships, reimbursement, and claims. * Interpret prescription drug orders using excellent medical and billing terminology. * Monitor and analyze claim rejections to identify system enhancements and prevent future issues. * Apply knowledge of Medicare and third-party billing procedures to ensure accurate submissions. * Communicate effectively across teams and stakeholders via meetings, email, and presentations. * Collaborate with revenue cycle departments to reduce denials and avoidable write-offs. * Analyze compliance issues, payor policies, coding discrepancies, and billable services. * Follow up on outstanding account balances at 45 days post-service to maximize reimbursement. * Uphold hospital core values in all decision-making and interactions. Qualifications: * 1-3 years in medical coding, finance, revenue cycle, patient accounting, or physician billing. * Experience in a Medical Center, Oncology, or Home/Office Infusion setting preferred. * Education: Bachelor's degree in Business, Healthcare, or a related field (or equivalent work experience). * Advanced understanding of professional billing flows and revenue cycle tasks. * Expertise in complex denials, payment variances, contracts, and fee schedules. * Strong analytical skills and ability to prepare reports for review. * Familiarity with Medicare and regulatory billing codes and practices. * Ability to educate and provide feedback on Pharmacy Revenue Cycle metrics. * Certifications (Preferred): Coding Certification (CPC, RHIT) Details: * 100% remote * Pay: $30 - $35/hr. based on related experience * Pay cycle - weekly \| medical, dental & vision benefits offered Pay and Benefits The pay range for this position is $30.00 - $35.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: * Medical, dental & vision * Critical Illness, Accident, and Hospital * 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available * Life Insurance (Voluntary Life & AD&D for the 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) Workplace Type This is a fully remote position. Application Deadline This position is anticipated to close on Aug 8, 2025. h4>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. About TEKsystems and TEKsystems Global Services We're a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We're a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We're strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We're building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com. The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.