$51,000 - 65,000 yearly
Number of Applicants
:000+
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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.
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.
The EDI (electronic data interchange) Claims Analyst 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 role is responsible for the establishment and ongoing monitoring of EDI files received from external partners for batch claim processing of subrogation and other payer claims. The EDI Claims Analyst position also requires knowledge of both the technical and operational sides of the business.
Individuals in this role will maintain a working knowledge of manual claim processing and will partner with development resources to champion the enhancement of current processing. This role will also work closely with Compliance, Finance and Government Programs teams to meet subrogation regulatory requirements. The EDI Claims Analyst will have direct authority to make sound business decisions regarding client claims EDI data and will demonstrate the ability to continually prioritize day to day workload to meet individual, departmental and organizational goals for service and performance.
This position may include after-hour and/or weekend hours depending on workload.
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