Navitus Health Solutions is seeking a Claims Analyst to join our team!
The Analyst, 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. The Analyst, Claims role is responsible for analyzing, documenting, and reporting findings of claim processing issues. Individuals in this role will interview stakeholders and research claim processing issues within the PBM claim processing system and will use the information to document the “how” and “why” of the claim processing issues.
The Analyst, Claims will work closely with benefit configuration analysts to gain an understanding of the benefit design and plan build. This position also collaborates with several Navitus departments including, but not limited to, Account Management, Provider Relations, Formulary Operations, and Information Technology to ensure Navitus is able to provide a versatile adjudication system to adapt to the continuous changes in the pharmacy benefit industry.
This position may include after-hour and/or weekend hours with other eligible team members depending on workload.
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