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Systems Analyst II, Claim Adjudication
US ClaroSystems Analyst II responsible for supporting claim adjudication technology functions at Navitus. Focused on resolving system issues and enhancing claim processing efficiency.
Posted 5/28/2026full-timeRemote • Idaho • 🇺🇸 United StatesMid-LevelSenior💰 $67,657 - $81,514 per yearWebsite
About the role
Key responsibilities & impact- Maintain detailed knowledge of the claim adjudication system capabilities and limitations
- Provide subject matter expertise, participate in the design of innovative solutions to improve system configuration, claim processing, and the accuracy and efficiency of claims processing
- Support large effort initiatives within the claims adjudication space
- Identify risk, deliver quantified fact-based supporting details and provide a recommendation and detailed plan for mitigation
- Mentoring of less experienced team members
- Ensure accurate security configuration within the claims adjudication platform to minimize unauthorized access
- Review and understand NCPDP workgroup outcomes, participate in appropriate NCPDP task groups, share industry best practices and standards
- Other duties as assigned
Requirements
What you’ll need- A two-year college or university degree and/or a minimum of three years of work experience is required
- Professional PBM industry work experience is required
- Knowledge of applicable data privacy practices and laws is preferred
- Healthcare industry practices and HIPAA knowledge
- Experience as a member of a multi-disciplinary team
- Understanding of Agile methodology a plus
- Participate in, adhere to, and support compliance program objectives
- The ability to consistently interact cooperatively and respectfully with other employees
Benefits
Comp & perks- Top of the industry benefits for Health, Dental, and Vision insurance
- 20 days paid time off
- 4 weeks paid parental leave
- 9 paid holidays
- 401K company match of up to 5% - No vesting requirement
- Adoption Assistance Program
- Flexible Spending Account
- Educational Assistance Plan and Professional Membership assistance
- Referral Bonus Program – up to $750!
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
claim adjudicationsystem configurationclaims processingrisk identificationsecurity configurationdata privacy practicesHIPAA knowledgeAgile methodology
Soft Skills
mentoringcooperative interactionrespectful communication