Navitus Health Solutions

Claims Operations Specialist

Navitus Health Solutions

full-time

Posted on:

Location Type: Office

Location: Earth City • Montana • United States

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Tech Stack

SQL

About the role

  • Manage day-to-day process (i.e. audit benefit accumulator files, work daily reject and QA reports; escalate as needed.
  • Troubleshoot and perform research on data integration issues, JIRA tickets, and escalations.
  • Support client readiness activities through participation in development and approval of testing, training, communication, and business process changes.
  • Translate business needs and processes into clear and concise procedural documentation with minimal guidance; ensure all documents are present and cataloged properly.
  • Regularly monitor client implementation activities, identify, and escalate any at-risk milestones.
  • Support the reporting needs of the department; develop and deliver reporting on an as-needed basis.
  • Ensure compliance with the organization’s strict data sharing and confidentiality guidelines.
  • Manage member and pharmacy related requests via Jira and resolve within the agreed upon SLAs.

Requirements

  • Recent graduate of a bachelor’s degree program, or equivalent
  • Knowledge of benefit accumulators, eligibility, and data extracts preferred.
  • Demonstrate effective adaptability to new technology.
  • Problem solving and analytical skills.
  • Proficient in Microsoft Windows, Excel and PowerPoint; SQL a plus
  • Interpret and use knowledge, facts, and data in problem solving.
  • Ability to work within a team structure, negotiate and manage conflict.
  • Strong communication skills (written and oral forms)
  • Strong organization, prioritization, and management skills to manage multiple initiatives with effective and accurate results.
  • Execute duties with the highest regard for integrity.
Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools
data integrationSQLreportingbenefit accumulatorsdata extracts
Soft Skills
problem solvinganalytical skillsadaptabilitycommunicationorganizationprioritizationconflict managementteamworkintegrity
Certifications
bachelor’s degree