Prime Therapeutics - Columbus, OH
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 a mission that helps people access the medications they need to improve their health and well-being. Your responsibilities will include adjudicating various types of claims and adjustments, resolving any claims edits or suspended claims, and maintaining up-to-date reference materials necessary for effective claims adjudication. You will also provide backup support to your team members as needed, fostering a collaborative work environment. The role requires a high level of attention to detail and adherence to claims payment policies, as well as compliance with customer and provider contractual agreements. You will be expected to utilize a 10-key machine efficiently and have familiarity with ICD-9 codes and Current Procedural Terminology (CPT). This position is ideal for individuals who thrive in a fast-paced and dynamic work environment, where proactive problem-solving and adaptability are key to success. At Prime Therapeutics, we value new ideas and encourage our employees to be involved and empowered in their roles, contributing to the highest quality of care and service for our members.