Claims Processor II

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 Processor II Job Description Summary Responsible and accountable for the accurate and timely claims processing of all claim types. Claims must be processed with a high level of detailed quality and in accordance with claims payment policy and by the terms of our customer/provider contractual agreements. Job Description 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. Responsibilities Ability to quickly use a 10-key machine Experience with list of ICD-9 codes and Current Procedural Terminology (CPT) Work Experience Work Experience - Required: Claims Work Experience - Preferred: Education Education - Required: GED, High School Education - Preferred: Certifications Certifications - Required: Certifications - Preferred: Potential pay for this position ranges from $16.00 - $23.39 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 ( and click on the "Benefits at a glance" button for more detail. Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information, veteran status, marital status, pregnancy or related condition (including breastfeeding), expecting or parents-to-be, or any other basis protected by law. We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law. Prime Therapeutics LLC is a Tobacco-Free Workplace employer. 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 proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information, veteran status, marital status, pregnancy or related condition (including breastfeeding), expecting or parents-to-be, or any other basis protected by law. We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law. Prime Therapeutics LLC is a Tobacco-Free Workplace employer. If you are an applicant with a disability and need a reasonable accommodation for any part of the employment process, please contact Human or email .

Created: 2024-11-01