Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. It fuels our passion and drives every decision we make.

Job Posting Title

Claims Lead

Job Description Summary

Adjudicate or submit claims and adjustments as required. Track and trend performance of root cause analysis and provide additional training as needed. Resolve claims edits and suspended claims.

Job Description

• Adjudicate or submit claims and adjustments as required.

• Implementation and maintenance of claims processing programs and procedures

• Verify that claims are being adjudicated or submitted according to Prime Therapeutics contracts in a consistent and accurate manner.

• Manage projects and administrative duties as required by business need.

• Lead and implement positive changes with a high level of quality and professionalism.

• Provide backup support to other team/group members in the performance of job

• Other duties as assigned

Responsibilities

• Ability to quickly use a 10-key machine

Work Experience

Work Experience - Required:

Claims

Work Experience - Preferred:

Education

Education - Required:

A Combination of Education and Work Experience May Be Considered., Bachelors

Education - Preferred:

Certifications

Certifications - Required:

Certifications - Preferred:

Potential pay for this position ranges from $20.76 - $31.14 based on experience and skills. Pay range may vary by 8% depending on applicant location.

To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page (https://www.primetherapeutics.com/careers/benefits/) and click on the "Benefits at a glance" button for more detail.

Prime Therapeutics LLC is an Equal Opportunity Employer and a Tobacco-free workplace . We encourage diverse candidates to apply and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender identity or expression, genetic information, marital status, family status, national origin, age, disability, veteran status, or any other legally protected class under federal, state, or local law. Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures .

Positions will be posted for a minimum of five consecutive workdays.

Prime Therapeutics' fast-paced and dynamic work environment is ideal for proactively addressing the constant changes in today's health care industry. Our employees are involved, empowered, and rewarded for their achievements. We value new ideas and work collaboratively to provide the highest quality of care and service to our members.

If you are looking to advance your career within a growing, team-oriented, award-winning company, apply to Prime Therapeutics today and start making a difference in people's lives.

Prime Therapeutics LLC is an Equal Opportunity Employer. We encourage diverse candidates to apply and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status. ​ If you are an applicant with a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources at 1.866.469.1257 or email Careers@primetherapeutics.com.