Specialty & Home Delivery Program Claims Analyst - Remote

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us.

Job Posting Title

Specialty & Home Delivery Program Claims Analyst - Remote

Job Description

The Specialty & Home Delivery Program Claims Analyst is responsible for serving as a Claims Operations subject matter expert on system functionality which may include implementations, projects, and testing for key Prime service offerings. This position is responsible for working with internal and external clients and serving as an escalation and mentoring resource on production issues.

Responsibilities

• Represent Claim Operations as subject matter expert (SME) on both internal and external projects, participating in all relevant functions on project lifecycle

• Identify, analyze, and implement system and process improvements using variety of personnel and data resources

• Translate complex details of system capabilities, enhancements, and implementations to non-technical resources, serving as main resource for department on training and documentation of new projects/processes

• Partner with Prime's Clients to identify, problem solve, and execute corrective measures

• Provide backup support to various roles within department with ability to serve as short-term stand-in for each position, when necessary

• Other duties as assigned

Minimum Qualifications

• Bachelor's degree in IT, Business, Science or related area of study, or equivalent combination of education and/or relevant work experience; HS diploma or GED is required

• 2 years of work experience in claims processing or project lifecycle, or related roles in the healthcare or PBM industry

• Must be eligible to work in the United States without need for work visa or residency sponsorship

Additional Qualifications

• Experience with Microsoft Office products

• Ability to work in fast paced, collaborative, team environment under strict deadlines

• Flexibility in job duties with ability to work on multiple tasks simultaneously

• Strong verbal, written, and interpersonal communication skills

• Strong analytical, organizational, time management, and problem-solving skills

• Strong attention to detail

Preferred Qualifications

• PBM industry knowledge

• 2 years of experience working with RxClaim

Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures

Every employee must be able to perform the essential functions of the job and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions, absent undue hardship. In addition, Prime retains the right to change or assign other duties to this job.

Potential pay for this position ranges from $59,000.00 - $94,000.00 based on experience and skills.

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, color, religion, gender, sex (including pregnancy), 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.

At Prime Therapeutics (Prime), we are a different kind of PBM. We're reimagining pharmacy solutions to provide the care we would want for our loved ones. That purpose energizes our team and creates limitless opportunities to make a difference.

We know that people make all the difference. If you're ready for a purpose-driven career and are passionate about simplifying health care, let's build the future of pharmacy together.

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 (including pregnancy), 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.

If you are an applicant with a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources at 1.866.469.1257 or email [email protected].