Lead Claims Processor, Government Programs Our work matters. We help people get the medicine they need to feel better and live well. It fuels our passion and drives every decision we make. 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. 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 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. Education Level: Bachelors. Fields of Study: Claims. Experience Level: 5+ years. 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, color, religion, gender, sex (pregnancy, sexual orientation, and gender identity), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local 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.