Claims Analyst

Navitus Health Solutions

. Collaborates with benefit configuration analysts and internal customers using sound business judgement and expertise to research and determine root causes for claim processing issues of low to moderate complexity.

Posted 4/29/2026full-timeRemote • Idaho • 🇺🇸 United StatesMid-LevelSenior💰 $49,911 - $59,418 per yearWebsite

About the role

Key responsibilities & impact

Collaborates with benefit configuration analysts and internal customers using sound business judgement and expertise to research and determine root causes for claim processing issues of low to moderate complexity.
Works simultaneously on multiple claim processing issues using subject matter expertise to enhance and improve the accuracy of claim processing.
Acquires and maintains an intermediate to advanced level of knowledge and interpretation of benefit designs and adjudication system screens and functions.
Applies advanced reporting and data analysis techniques to identify error types, root causes and quantity of claims affected.
Establishes and utilizes standard templates to document and share a comprehensive summary of findings including a systemic impact analysis with CAO leadership and all relevant functional areas.
Recommends retraining, new training and/or corrective action plans based on findings and works closely with benefit configuration trainers and coaches to take appropriate action to mitigate future occurrences and financial risk to client and/or Navitus.
Adapts to industry changes and evolving technology, maintaining an intermediate to advanced level of understanding of both legacy and emerging products and systems.
Uses departmental workflow management, issue resolution and reporting tools for troubleshooting and responding to moderate to complex customer requests.
Independently assesses business needs and participates in process improvement, cost reduction and automation efforts.

Requirements

What you’ll need

Associate's degree or equivalent work experience required.
Basic knowledge of applications used within operational processes for ability to perform tasks with minimal guidance required, typically with less than 1 year of experience.
Experience with the following tools at an intermediate to advanced level preferred: Claims Processing, Microsoft Office (Word, Excel, PowerPoint), Formulary Management, Request Management (Connectus, Service Desk), Reporting (3D QlikView/QlikSense).
Participate in, adhere to, and support compliance program objectives.
The ability to consistently interact cooperatively and respectfully with other employees.

Benefits

Comp & perks

Health insurance
401K company match of up to 5% - No vesting requirement
20 days paid time off
4 weeks paid parental leave
9 paid holidays
Adoption Assistance Program
Flexible Spending Account
Educational Assistance Plan and Professional Membership assistance
Referral Bonus Program – up to $750!

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

data analysisreportingclaim processingroot cause analysisprocess improvementcost reductionautomation

Soft Skills

collaborationbusiness judgementcommunicationadaptabilityproblem-solving

Certifications

Associate's degree