Tester, Benefit Configuration

Navitus Health Solutions; United States; Remote; USD 45,000 - 60,000; Full time

Job summary

Navitus Health Solutions is seeking a Tester for Benefit Configuration to enhance the claims adjudication operations of their pharmacy benefit management system. In this entry-level role, you'll perform testing tasks to ensure the accuracy and integrity of pharmacy claims processing while collaborating across departments. Ideal candidates should have an Associate’s degree or relevant experience and a basic understanding of systems and processes. This full-time, remote position offers a chance to contribute to crucial operations in healthcare.

Qualifications

• Associate’s degree or relevant experience required.
• Basic understanding of systems and processes.
• Ability to perform tasks with supervision.

Responsibilities

• Conduct benefit configuration testing for new client implementations and changes.
• Participate in root cause analysis and contribute to process improvements.
• Collaborate with various departments to ensure accurate testing.

Skills

Understanding of systems and processes

Basic experience with Microsoft Word

Basic experience with Microsoft Excel

Education

Associate’s degree or equivalent work experience

Job description

Join to apply for the Tester, Benefit Configuration role at Navitus Health Solutions.

About Us
Navitus - Putting People First in Pharmacy. Navitus was founded as an alternative to traditional pharmacy benefit manager (PBM) models. We are committed to removing costs from the drug supply chain to make medications more affordable. Our team values diversity, fosters creativity, and encourages growth. We welcome new ideas and share a passion for excellent service.

Work Schedule
M-F 8am to 5pm

Overview
The Tester, Benefit Configuration ensures efforts align with the Claim Adjudication Operations (CAO) team to leverage technology and process improvements for meeting business needs. The role involves performing and documenting benefit configuration testing to maintain an accurate and efficient claims adjudication system. It includes developing tasks to incorporate client and company initiatives into testing to ensure the integrity of pharmacy claims processing.

The Tester will collaborate with various departments to ensure accurate testing of benefit designs and claims adjudication, adapting to industry changes. The position may include after-hours or weekend hours depending on workload.

Responsibilities

• Complete scheduled and urgent benefit configuration testing for new client implementations and benefit changes accurately and timely.
• Understand Navitus' claims adjudication system and processes to test configurations effectively.
• Contribute to root cause analysis of issues using sound judgment.
• Comply with standards regarding benefit design and testing, including HIPAA, NCPDP, and internal standards.
• Utilize workflow management and reporting tools for troubleshooting and responding to customer questions.
• Participate in client meetings, audits, and new program implementations, providing guidance on testing processes.
• Maintain understanding of industry and technology changes, including legacy and emerging products.
• Assess business needs and participate in process improvements and automation efforts.
• Assist in creating and maintaining training materials, work instructions, and policies.
• Conduct system enhancement and regression testing to ensure compliance with regulations.
• Support training and mentorship within the team.
• Adhere to compliance, diversity, equity, and inclusion objectives.
• Perform other duties as assigned.

Qualifications

• Associate’s degree or equivalent work experience.
• Basic understanding of systems and processes with ability to perform tasks with supervision.
• Basic experience with Microsoft Word and Excel.

Location: Remote, US

Seniority level: Entry level

Employment type: Full-time

Job function: Engineering and Information Technology

Industries: Hospitals and Health Care

Note: This job posting is active. Current associates should use SSO login at https://employees-navitus.icims.com/ for internal opportunities.