Claims Technical Analyst, Sr.

Claims Technical Analyst, Sr. 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 Technical Analyst, Sr. Job Description The Senior Claims Technical Analyst is responsible for serving as the claims analysis resource for assigned operations teams. This role is responsible for performing complex and escalated client, member and pharmacy remediation analysis. This role is also responsible for providing training and mentorship to Claims Technical Analysts and Associate Analysts, along with leading process improvement and technology uplift efforts for department level applications. Responsibilities + Serve as lead Analyst for complex and/or escalated analysis requests; coordinate requests from internal and external clients and establish timelines, as well as presenting results + Train Claims Technical Analysts and Associate Analysts on specific job functions; maintain training material and present materials in shadowing and classroom settings + Review, perform root cause analysis, and monitor system defects on escalated issues; diagnose claim issues, assess claim trends, develop solutions and initiate appropriate claim resolution strategies + Partner with cross functional teams to maintain, troubleshoot and improve analysis tools (Query tool requirements and Claims Reprocessing Tool Mechanism) and processes + Develop and perform documented test case scenarios to support existing and newly developed tools and applications + Other duties as assigned Minimum Qualifications + 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; HS diploma or GED required + 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 Additional Qualifications + Strong negotiation and persuasion skills + Strong verbal and written communication skills + Ability to coordinate multiple projects/tasks simultaneously under strict timelines + Strong analytical, problem solving, and decision-making skills + Ability to work in fast-paced, collaborative team environment + Advanced level Microsoft Excel Analysis Skills + Ability to present complex material to a variet To view full details and how to apply, please login or create a Job Seeker account