Prime Therapeutics - Harrisburg, PA
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 medicine they need to feel better and live well. You will be responsible for adjudicating claims and adjustments, resolving claims edits, and managing suspended claims. Your attention to detail and adherence to claims payment policies will be essential in maintaining the integrity of our claims processing system. In this role, you will also be tasked with maintaining and updating the necessary reference materials required for adjudicating claims. This ensures that you are always equipped with the most current information to make informed decisions. Additionally, you will provide backup support to other team members, fostering a collaborative work environment where everyone contributes to the team's success. The ideal candidate will have experience in claims processing and a strong understanding of ICD-9 codes and Current Procedural Terminology (CPT). Your ability to quickly use a 10-key machine will be vital in efficiently processing claims. We are looking for individuals who are proactive, detail-oriented, and ready to thrive in a fast-paced and dynamic work environment that is constantly evolving to meet the needs of the healthcare industry.