Prime Therapeutics - Providence, RI
posted about 2 months ago
As a Claims Processor at Prime Therapeutics, you will play a crucial role in ensuring that claims are processed accurately and in a timely manner. This position is fully remote, allowing you to work from the comfort of your home while contributing to our mission of helping people access the medications they need. You will be responsible for adjudicating various types of claims and adjustments, resolving any claims edits or suspended claims that may arise during the processing phase. Your attention to detail and adherence to claims payment policies will be essential in maintaining the integrity of our operations and ensuring compliance with customer and provider contractual agreements. In this role, you will also be tasked with maintaining and updating the necessary reference materials that are vital for the accurate adjudication of claims. This includes staying informed about the latest updates in claims processing and ensuring that all procedures are followed meticulously. Additionally, you will provide backup support to other team members, fostering a collaborative environment where everyone can succeed together. Your contributions will directly impact the quality of care we provide to our members, making this position both rewarding and significant. Prime Therapeutics is committed to creating a dynamic and fast-paced work environment that adapts to the ever-changing landscape of the healthcare industry. We value our employees and encourage them to share new ideas and work collaboratively to enhance our services. If you are looking for a position that not only offers career advancement opportunities but also allows you to make a meaningful difference in people's lives, this is the role for you.