Prime Therapeutics - Washington, DC
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 have the most current information at your fingertips 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. Your ability to quickly and accurately use a 10-key machine will be vital in processing claims efficiently. Familiarity with ICD-9 codes and Current Procedural Terminology (CPT) will also be beneficial as you navigate through various claims types. This position not only requires technical skills but also a commitment to quality and customer service, as you will be directly impacting the lives of our members by ensuring they receive the care they need.