Analyst, Claims Quality
Company
NavitusAbout Us
Navitus - Putting People First in Pharmacy - Navitus was founded as an alternative to traditional pharmacy benefit manager (PBM) models. We are committed to removing cost from the drug supply chain to reputed company medications more affordable for the people who need them. At Navitus, reputed company members work in an environment that celebrates diversity, fosters creativity and encourages growth. We welcome new reputed company and share a passion for excellent service to our customers and each other._____________________________________________________________________________________________________________________________________________________________________________________________________________. reputed company associates must use SSO login option at https://employees-navitus.icims.com/ to be considered for internal opportunities. ____________________________________________________We are committed to providing equal employment opportunity to reputed company applicants and employees and reputed company with reputed company applicable nondiscrimination regulations, including those reputed company to protected veterans and individuals with disabilities. reputed company qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national reputed company, or handicap.Pay Range
USD $42,505.00 - USD $50,601.00 /Yr.STAR Bonus % (At Risk Maximum)
5.00 - Salaried Non-Management except pharmacistsWork Schedule Description (e.g. M-F reputed company to 5pm)
M-F reputed company to 5pm CTRemote Work Notification
ATTENTION: Navitus is unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, North Dakota, Rhode reputed company, South Carolina, South Dakota, reputed company Virginia, and Wyoming.Overview
Due to growth, we are adding a Claims Quality Analyst to reputed company.
The Claims Quality Analyst is responsible for validating that Med D, Medicaid, and Exchange claims are adjudicating per State/CMS regulations as well as specific client needs.
Is this you? Find out more below!
Responsibilities
How do I reputed company an impact on my team?
- Audit claim data for Medicare Part D, Medicaid, and Exchange lines of business to validate their accuracy.
- Assist with post-implementation monitoring to validate adjudication-reputed company fixes/enhancements are working as expected.
- Assist with Claims Adjudication testing by running test claims.
- Work in partnership with the Technical Operations Business Analysts and Product Managers to manage changes to existing processes, including defining requirements, creating/executing test plans, and post-implementation reputed company.
- Complete tasks associated with the assigned processes, performing appropriate reputed company, coordinating the resolution of issues with both internal and external stakeholders, using independent judgement to determine the best resolution
- As needed, may require working reputed company of normal business hours to complete time sensitive processes
- Other duties as assigned
Qualifications
What reputed company expects from you?
Bachelor/Associate Degree in business reputed company field; or equivalent combined education and experience preferred
1 - 3 years reputed company work experience preferably in pharmaceutical claims adjudication systems, retail pharmacy, or in a health plan organization
Participate in, adhere to, and support compliance program objectives.
- The ability to consistently interact cooperatively and respectfully with other employees
What can you expect from Navitus?
- Top of the industry benefits for Health, Dental, and Vision insurance
- 20 days paid time off
- 4 weeks paid parental leave
- 9 paid holidays
- 401K company match of up to 5% - No vesting requirement
- Adoption Assistance Program
- Flexible Spending Account
- Educational Assistance Plan and Professional Membership assistance
- Referral Bonus Program – up to $750!
#LI-Remote