Medical Claims Examiner

6 hours ago


Lincoln, Nebraska, United States Prime Therapeutics Full time
Job Summary

We are seeking a skilled Medical Claims Examiner to join our team at Prime Therapeutics. As a key member of our operations team, you will be responsible for the accurate and timely processing of medical claims. Your attention to detail and ability to work independently will be essential in ensuring the high-quality service we provide to our members.

Key Responsibilities

* Adjudicate claims and adjustments in accordance with claims payment policy and customer/provider contractual agreements
* Resolve claims edits and suspended claims
* Maintain and update reference materials to adjudicate claims
* Provide backup support to other team members as assigned

Requirements

* Ability to quickly use a 10-key machine
* Experience with ICD-9 codes and Current Procedural Terminology (CPT)
* High school diploma or equivalent required, with a preferred certification in a related field

What We Offer

* Competitive salary range of $16.00 - $23.39 based on experience and skills
* Opportunities for professional growth and development
* A dynamic and supportive work environment

Equal Opportunity Employer

Prime Therapeutics is an equal opportunity employer and welcomes diverse candidates to apply. We are committed to providing a workplace that is free from discrimination and harassment, and where all employees feel valued and respected.

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