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    Claims Specialist - Boise, United States - Idaho State Job Bank

    Idaho State Job Bank
    Idaho State Job Bank Boise, United States

    3 weeks ago

    Idaho State Job Bank background
    Description
    Claims Specialist (Hybrid - Eagan, MN) at Prime Therapeutics in Boise, Idaho, United States Job Description 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 Specialist (Hybrid - Eagan, MN) Job Description The Claims Specialist is responsible for assisting in the ongoing operational support of Prime key service offerings.

    This position is responsible for responding to inquires from internal and external partners for the research of and resolution of claim issues.

    Additionally, this position serves as a subject matter expert resource for coworkers and other departments.

    Responsibilities + Work in Medicare, Commercial and Health Insurance Marketplace (HIM) integrity lines of business to ensure strict adherence to unique guidelines and regulations for each + Monitor and respond appropriately to incoming inquiries related to specific process or support systems (e.g.

    claim adjudication system) Escalate issues when appropriate + Partner with Prime's clients to produce and execute corrective measures found in key service offerings + Process authorizations to meet HIPAA/privacy and CMS requirements + Sorts, researches and processes daily internal and external documents received by the mailroom. + Assist with RxClaim Release user acceptance testing and reporting + Serve as a subject matter expert (SME) resource for other departments + Ability to come into Prime's office in Eagan, MN on a rotational basis (1 time a week every 5 weeks) + Other duties as assigned Minimum Qualifications + High school diploma from accredited institution or equivalent GED + 1 year of claims experience + Must be eligible to work in the United States without need for work visa or residency sponsorship Additional Qualifications + Experience with Microsoft Office products + Strong written and verbal communication skills + Strong organizational skills + Ability to work independently + Strong attention to detail with ability to perform with high degree of accuracy + Ability to prioritize and handle multiple tasks simultaneously Preferred Qualifications + 2+ years of experience in claims, insurance, or healthcare + Extensive experience using Excel spreadsheets Minimum Physical Job Requirements + Constantly required to sit, use hands to handle or feel, talk and hear + Frequently required to reach with hands and arms + Occasionally required to stand, walk and stoop, kneel, and crouch + Occas To view full details and how to apply, please login or create a Job Seeker account
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