Senior Claims Technical Analyst
4 weeks ago
We are seeking a highly skilled Senior Claims Technical Analyst to join our team at Prime Therapeutics. As a key member of our PBM Operations team, you will be responsible for serving as the claims analysis resource for assigned operations teams.
Key Responsibilities:- Serve as lead analyst for complex and/or escalated analysis requests, coordinating requests from internal and external clients and establishing timelines.
- Train Claims Technical Analysts and Associate Analysts on specific job functions, maintaining training material and presenting materials in shadowing and classroom settings.
- Review, perform root cause analysis, and monitor system defects on escalated issues, diagnosing claim issues, assessing claim trends, developing solutions, and initiating appropriate claim resolution strategies.
- Partner with cross-functional teams to maintain, troubleshoot, and improve analysis tools and processes.
- Develop and perform documented test case scenarios to support existing and newly developed tools and applications.
- Bachelor's degree in Business, Computer Science, IT, Mathematics, Finance, or related area of study, or equivalent combination of education and/or relevant work experience.
- 5 years of work experience in data analysis, including 2 years of experience working with claims data or systems.
- Must be eligible to work in the United States without need for work visa or residency sponsorship.
- Training experience.
- 2 years of experience working with RxClaim system.
Prime Therapeutics offers a competitive salary range of $64,000 to $97,100 based on experience and skills. Additionally, we offer a comprehensive benefits package, including medical, dental, and vision insurance, 401(k) matching, and paid time off.
We are an equal opportunity and affirmative action employer, committed to diversity and inclusion. We welcome applicants from diverse backgrounds and encourage qualified candidates to apply.
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