[Remote] Analyst, Benefit Configuration

Remote Full-time
Note: The job is a remote job and is open to candidates in USA. Navitus Health Solutions is seeking an Analyst, Benefit Configuration to join our team! The Analyst will ensure alignment with the Claim Adjudication Operations team by accurately administering benefits and configuring them in the claim adjudication system based on specifications from internal and external customers. 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 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 Independently assesses business needs and participates in process improvement, cost reduction and automation efforts Contributes to the creation and ongoing maintenance of departmental training materials, work instructions and policies Conducts system enhancement and regression testing of a low to moderate level of complexity for benefit configuration processes to ensure compliance with state, federal and client regulations/standards Contributes to training and maintains a mentoring relationship with new and existing benefit configuration team members Participate in, adhere to and support compliance and diversity, equity, and inclusion program objectives Other duties as assigned Skills Associate's degree or equivalent work experience required Minimal experience and/or training to begin learning skills, systems, and processes of the role with ability to perform tasks with close supervision 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 Benefits 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! Company Overview Navitus Health Solutions LLC is a full service, URAC-accredited pharmacy benefit management company. It was founded in 2003, and is headquartered in Appleton, Wisconsin, USA, with a workforce of 1001-5000 employees. Its website is
Apply Now

Similar Opportunities

Experienced Registered Behavior Technician for In-Home ABA Therapy - Atlanta, GA

Remote Full-time

Immediate Hiring: Experienced Registered Behavioral Technician (RBT) for Clinic-Based ABA Therapy Services

Remote Full-time

Experienced Registered Behavioral Technician (RBT) - ABA Therapy for Children with Autism Spectrum Disorder

Remote Full-time

Experienced Registered Nurse - Telehealth: Providing Remote Care Coordination and Patient Support

Remote Full-time

Experienced Substitute Teacher for Riverside County Schools - Join Scoot Education's Innovative Team

Remote Full-time

Experienced Substitute Teacher for San Bernardino County - Flexible Schedules & Competitive Pay

Remote Full-time

Experienced School Year Instructional Coach for High-Dosage Tutoring Programs in Edgewater Park, NJ

Remote Full-time

Experienced School Year Tutor for K-8 Students in Math and Literacy - Mickleton, NJ

Remote Full-time

Experienced Secondary Social Studies Teacher for Kansas - Flexible Hybrid Remote Arrangement

Remote Full-time

USPS Office Helper

Remote Full-time

Part Time Work From Home Remote Data Entry - Teen Jobs

Remote Full-time

Product Manager 2, Merchandising - Nordstrom Product Group - Hybrid (Seattle, WA)

Remote Full-time

Specialist, Government Contracts - Remote in EST

Remote Full-time

Remote Supervisor Specialty Pharmacy - Military Veterans

Remote Full-time

Experienced Part-Time Data Entry Specialist - Work From Home at $22/H - No Experience Required - Blithequark's Dynamic Remote Team

Remote Full-time

Experienced Customer Service Professional – Live Chat Specialist for Remote Work Opportunity with blithequark

Remote Full-time

[Remote] Customer Service and Sales Specialist

Remote Full-time

**Experienced Customer Service and Medical Receptionist – Remote Opportunity with arenaflex**

Remote Full-time

Commercial Account Executive

Remote Full-time

Experienced Medical Customer Service Representative – Remote Opportunity for Goal-Driven Individuals with Excellent Communication Skills

Remote Full-time
← Back to Home