Note: The job is a remote job and is open to candidates in USA. Navitus Health Solutions is a company focused on improving pharmacy benefits and making medications more affordable. They are seeking a Tester, Benefit Configuration to ensure accurate benefit configuration testing and alignment with the Claim Adjudication Operations team, which is essential for maintaining an efficient claims adjudication system.
Responsibilities
- Completes scheduled and urgent benefit configuration testing of new client implementations and/or benefit additions, terminations, and changes timely and accurately to mitigate the risk of member access to care issues, missed performance guarantees and potential liquidated damages
- Acquires and maintains a basic level of understanding of Navitus’ claims adjudication system and upstream/downstream processes to test both standard and custom configurations to meet client expectations
- Uses sound business judgment and expertise to contribute toward the creation of root cause analysis of issues
- Complies with standards set forth regarding benefit design and configuration testing including HIPAA, NCPDP and Navitus internal business standards
- 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 testing questions and providing guidance to other areas and roles on the benefit configuration testing 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 testing team members
- 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
- Experience on basics and gaining familiarity with the role and company
- 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 https://www.navitus.com/.Company H1B Sponsorship
Navitus Health Solutions has a track record of offering H1B sponsorships, with 1 in 2022. Please note that this does not guarantee sponsorship for this specific role.
Apply Now