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Navitus Health Solutions · 6 hours ago

Analyst, Benefit Configuration

United States

Full-time

Remote

New Grad, Entry Level

$20/hr - $23/hr

Navitus Health Solutions is seeking an Analyst, Benefit Configuration to join our team! The Analyst will ensure alignment with the Claim Adjudication Operations team by accurately administering benefits and configuring them in the claim adjudication system based on specifications from internal and external customers.

Health CareInformation Technology

Responsibilities

Completes scheduled and urgent benefit additions, terminations, and changes timely and accurately to prevent member access to care issues, missed performance guarantees and potential liquidated damages

Acquires and maintains a basic level of knowledge and interpretation of multiple adjudication system screens and functions on a field-by-field level to design both standard and custom configurations to meet client expectations

Complies with standards set forth regarding benefit design and configuration including HIPAA, NCPDP and Navitus internal business standards

Performs quality assurance peer reviews and uses sound business judgment and expertise to contribute toward the creation of root cause analysis of issues

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 setup questions and providing guidance to other areas and roles on the benefit configuration 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 team members

Participate in, adhere to and support compliance and diversity, equity, and inclusion program objectives

Other duties as assigned