Prime Therapeutics - Providence, RI
posted 2 months ago
As a Claims Lead at Prime Therapeutics, you will play a crucial role in ensuring that claims are processed accurately and efficiently. Your primary responsibilities will include adjudicating or submitting claims and adjustments as required, as well as implementing and maintaining claims processing programs and procedures. You will verify that claims are being adjudicated or submitted in accordance with Prime Therapeutics contracts, ensuring consistency and accuracy in all transactions. In addition to claims processing, you will manage various projects and administrative duties as dictated by business needs. Your leadership will be essential in driving positive changes within the team, maintaining a high level of quality and professionalism in all aspects of your work. You will also provide backup support to other team members, ensuring that the workflow remains uninterrupted and efficient. Other duties may be assigned as necessary, allowing you to contribute to the overall success of the organization. This position requires a proactive approach to problem-solving, as you will be responsible for tracking and trending performance through root cause analysis. You will also provide additional training as needed to ensure that all team members are equipped with the necessary skills to perform their roles effectively. Your ability to quickly use a 10-key machine will be essential in this fast-paced environment, where accuracy and speed are paramount.