Claims Processor- REMOTE

$33,280 - $48,651/Yr

Prime Therapeutics - Baton Rouge, LA

posted about 2 months ago

Full-time - Entry Level
Remote - Baton Rouge, LA
Administrative and Support Services

About the position

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. You will be responsible for adjudicating claims and making necessary 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 required reference materials that are necessary for adjudicating claims. This will involve staying current with the latest coding practices, including ICD-9 codes and Current Procedural Terminology (CPT). Additionally, you will provide backup support to other team members, ensuring that the workflow remains uninterrupted and that all claims are processed efficiently. The fast-paced and dynamic work environment at Prime Therapeutics is designed to empower employees to proactively address the constant changes in the healthcare industry. We value collaboration and innovation, and you will have the opportunity to contribute your ideas and insights to improve our processes and services. If you are looking for a position where you can make a meaningful impact and advance your career within a supportive and award-winning company, this is the role for you.

Responsibilities

  • Adjudicates claims and adjustments as required.
  • Resolves claims edits and suspended claims.
  • Maintains and updates required reference materials to adjudicate claims.
  • Provides backup support to other team/group members in the performance of job duties as assigned.

Requirements

  • Experience in claims processing is required.
  • Ability to quickly use a 10-key machine.
  • Familiarity with ICD-9 codes and Current Procedural Terminology (CPT) is preferred.
  • High School diploma or GED is required.

Nice-to-haves

  • Certifications related to claims processing are preferred.

Benefits

  • Competitive pay ranging from $16.00 - $23.39 based on experience and skills.
  • Diverse and inclusive workplace culture.
  • Opportunities for career advancement within a growing company.
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