Remote Pharmacy Reimbursement Specialist

Navitus; Salt Lake City (UT); Remoto; USD 65.000 - 90.000; Tempo pieno

Vantaggi offerti da questo lavoro

Paid time off 20 days

Parental leave 4 weeks

9 paid holidays

401K company match 5%

Adoption Assistance Program

Flexible Spending Account

Educational Assistance Plan

Professional Membership assistance

Referral Bonus Program – up to $750

Descrizione del lavoro

Navitus Health Solutions seeks a Pharmacy Reimbursement Administrator (PRA) to collaborate with Provider Relations, IT Client Operations, and others to optimize claims adjudication processes and ensure compliance with pharmacy contract agreements. The PRA handles remittances, EFT and 835 remittance data, and oversees recoveries from pharmacies while generating routine performance reports.

The role involves testing pharmacy networks, updating procedures, and responding to payment-related

Competenze

• Associate degree or equivalent experience.
• CPhT preferred.

Mansioni

• Administers technical processes in support of system price setups and remittance setups according to policy.
• Provides appropriate controls and oversight reporting on end-to-end processes.
• Resolves pharmacy network pricing setup issues and researches inquiries.
• Develops processes to import/export data from Navitus systems.
• Responsible for pharmacy network rate testing, analysis and impact assessment.
• Performs quality assurance to ensure accuracy in network rates to prevent incorrect claims.

Formazione

Associate degree or equivalent experience

CPhT (Pharmacy Technician)

Descrizione del lavoro

Navitus Health Solutions seeks a Pharmacy Reimbursement Administrator (PRA) to collaborate with Provider Relations, IT Client Operations, and others to optimize claims adjudication processes and ensure compliance with pharmacy contract agreements. The PRA handles remittances, EFT and 835 remittance data, and oversees recoveries from pharmacies while generating routine performance reports.

The role involves testing pharmacy networks, updating procedures, and responding to payment-related