Remote Pharmacy Reimbursement Specialist

Navitus; Frankfort (KY); Teletrabalho; USD 70 000 - 95 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Health, dental, and vision insurance

20 days paid time off

4 weeks paid parental leave

9 paid holidays

401K company match up to 5%

Adoption Assistance Program

Flexible Spending Account

Educational Assistance Plan and Pro. M

Referral Bonus Program - up to $750

Resumo da oferta

Navitus Health Solutions is seeking a Pharmacy Reimbursement Administrator to join our team. The PRA partners with providers and IT to review and update procedures, test networks, and oversee remittance and recoveries. Responsibilities include data integrity, pricing testing, and generating reports on reimbursement activities.

Qualified candidates may have an Associate degree and CPhT. PBM or managed care experience is preferred.

Qualificações

• Prior experience in pharmacy reimbursement or PBM environments preferred.
• Familiarity with testing processes and quality controls.
• Strong collaboration and compliance mindset.

Responsabilidades

• Administers processes for system price setups, EFT and remittance setups per policy.
• Maintains controls and reporting on end-to-end process; defines new controls as needed.
• Resolves pharmacy network pricing setup issues and researches pricing inquiries.
• Develops data import/export processes between Navitus systems and related databases.
• Tests pharmacy network rates, analyzes impact, and supports QA to ensure accuracy.

Conhecimentos

PBM experience

Managed care

Testing experience

Interpersonal communication

Formação académica

Associate degree

CPhT preferred

Descrição da oferta de emprego

Navitus Health Solutions is seeking a Pharmacy Reimbursement Administrator to join our team. The PRA partners with providers and IT to review and update procedures, test networks, and oversee remittance and recoveries. Responsibilities include data integrity, pricing testing, and generating reports on reimbursement activities.

Qualified candidates may have an Associate degree and CPhT. PBM or managed care experience is preferred.