Navitus Health Solutions is seeking a Manual Claims Coordinator to join our team!
The Coordinator, Manual Claims ensures efforts are in alignment with the Claim Adjudication Operations (CAO) team to leverage technology and process improvement for the purpose of meeting the business needs of Navitus customers, clients, members, and pharmacies by accurately administering benefits. This position is responsible for processing of pharmacy and/or direct member reimbursement (DMR) claims of all levels of complexity to execute the claims adjudication process including correction of claims.
The Coordinator, Manual Claims will manage the day-to-day processes and changes made to a client’s benefit or a pharmacy’s contract. This role requires knowledge of both the technical and operational sides of the business. The Coordinator, Manual Claims will have direct authority to make sound business decisions with regard to processing of a claim. The Coordinator, Manual Claims will collaborate closely with Member Services, Clinical Services, Client Services, Benefit Configuration, and Government Programs to understand the interdependences of each team pertaining to processing of manual claims.
This position may include after-hour and/or weekend hours depending on workload.
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