Analyst, Benefit Configuration
United States
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 make medications more affordable for the people who need them. At Navitus, our team members work in an environment that celebrates diversity, fosters creativity and encourages growth. We welcome new ideas and share a passion for excellent service to our customers and each other.Pay Range
USD $19.60 - USD $21.26 /Hr.Work Schedule Description (e.g. M-F 8am to 5pm)
M-F 8am to 5pm CSTRemote Work Notification
ATTENTION: We are unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming.Overview
Due to growth, we are adding an Analyst, Benefit Configuration to our CAO Implementation department.
This position 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 Benefit Configuration Analyst configures benefits in the claim adjudication system based on specifications from internal customers and external clients. This role applies knowledge of highly diverse plan designs, formularies, and networks across multiple lines of business, ensuring that claims adjudicate accurately and timely. Individuals in this role must use sound business judgement and demonstrate the ability to continually prioritize tasks, as customer experience and client financials are directly influenced by their quality of work.
This position may include after-hour and/or weekend hours with other eligible team members depending on workload.
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Responsibilities
- 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 …
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Hawaii Maine Mississippi New Hampshire New Mexico No remote work for residents of Alaska Rhode Island South Carolina South Dakota West Virginia Wyoming
Benefits/Perks20 days paid time off 20 Days PTO 401k company match 401(k) match 4 weeks 4 weeks paid parental leave 4 weeks parental leave 9 Paid Holidays Adoption Assistance Creativity Dental Dental Insurance Diversity Educational Assistance Flexible Spending Account Health Health insurance Paid holidays Paid parental leave Paid Time Off Parental leave Referral Bonus Remote work Vision Insurance
Tasks- Conduct system testing
- Issue resolution
- Maintain training materials
- Perform quality assurance
Benefit configuration Claim adjudication Compliance Creativity Customer Experience Excel Health HIPAA Implementation Insurance Issue Resolution Microsoft Office NCPDP Pharmacy Process Improvement Quality Assurance Reporting Root Cause Analysis Testing Training Troubleshooting Word Workflow Management
Experience0 years
EducationAssociate degree Business Equivalent work experience Quality Assurance Training
TimezonesAmerica/Anchorage America/Chicago America/Denver America/Los_Angeles America/New_York Pacific/Honolulu UTC-10 UTC-5 UTC-6 UTC-7 UTC-8 UTC-9