Claims Analyst

6 days ago

🐻 Alaska – Remote

Although this job is listed in Alaska, this company may be open to hiring remote in other states.

🌺 Hawaii – Remote

Although this job is listed in Hawaii, this company may be open to hiring remote in other states.

+10 more states

🐻 Alaska – Remote 🌺 Hawaii – Remote 🦞 Maine – Remote 🗻 New Hampshire – Remote 🌶️ New Mexico – Remote 🎸 Mississippi – Remote ⚓ Rhode Island – Remote 🌴 South Carolina – Remote 🗿 South Dakota – Remote ⚔️ Virginia – Remote ⛰️ West Virginia – Remote 🦬 Wyoming – Remote

💵 $49.9k - $59.4k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Analyst

Apply Now

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Microsoft 365

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Microsoft 365 is a cloud-based suite of productivity applications designed for individuals, families, businesses, and educational institutions. It includes popular tools such as Word, Excel, PowerPoint, Outlook, and Teams, providing users with the ability to create, collaborate, and share documents and data seamlessly across devices. Microsoft 365 enhances productivity with features like Microsoft Copilot, which integrates AI capabilities to assist users in their everyday tasks, ensuring secure storage and organization of files while facilitating effective teamwork and communication.

10,000+ employees

🤝 B2B

👥 B2C

☁️ SaaS

📋 Description

• Navitus Health Solutions is seeking a Claims Analyst to join our CAO Support 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 Claims Analyst 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 Claims Analyst 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.

🎯 Requirements

• Bachelor’s degree or equivalent work experience • Minimum of four (4) years of experience in NaviClaimRx or other table-based claims processing systems preferred • Experience with the following tools at an intermediate to advanced level preferred: Claims Processing, Microsoft Office (Word, Excel, PowerPoint), Formulary Management, Request Management (Connectus, Service Desk), and Reporting (3D QlikView/QlikSense) • 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!