Navitus Health Solutions is seeking a Benefit Configuration Analyst to join our Claim Adjudication Operations team.
The Analyst I, Benefit Configuration position is responsible for analysis, interpretation, integration and business decisions with regards to hierarchy, pharmacy network rates and Navitus’ formulary configuration designs. This position requires knowledge of both the technical and operational sides of the business utilizing Navitus’ adjudication system (NaviClaimRx) and/or other applications which includes software updates and enhancements. This position may include after-hour and/or weekend hours with other eligible team members depending on workload.
Is this you? Find out more below!
How do I make an impact on my team?
Completes scheduled and urgent benefit additions, terminations, and changes timely and accurately to prevent member access to care issues, missed performance guarantees and potential liquidated damages.
Acquires and maintains a basic level of knowledge and interpretation of multiple adjudication system screens and functions on a field-by-field level to design both standard and custom configurations to meet client expectations.
Complies with standards set forth regarding benefit design and configuration including HIPAA, NCPDP and Navitus internal business standards.
Performs quality assurance peer reviews and uses sound business judgment and expertise to contribute toward the creation of root cause analysis of issues.
Uses departmental workflow management, issue resolution and reporting tools for troubleshooting and responding to general customer questions and issue resolution requests.
Supports internal customers by participating in client meetings, audits and new program implementations with other areas of the company, answering benefit setup questions and providing guidance to other areas and roles on the benefit configuration process.
Adapts to industry changes and evolving technology, maintaining a basic level of understanding of both legacy and emerging products and systems.
Other duties as assigned
What our team expects from you?
Associate degree or equivalent work experience
Basic experience with Microsoft Office, specifically Word and Excel
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!
We are unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, North Dakota, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming.
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