Reimbursement Specialist I

Job not on LinkedIn

🕒 June 25

🇺🇸 United States – Remote

💵 $18 - $21 / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 31%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Navitus Health Solutions

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2003

💼 Consulting

🛡️ Insurance

🏥 Healthcare

Consulting • Insurance • Healthcare

Navitus Health Solutions is a pharmacy benefit manager (PBM) that provides transparent, people-centered pharmacy benefit solutions to health plans, employers, government programs and other plan sponsors. The company operates a 100% pass-through, cost-plus model that emphasizes lowering medication costs, managing formularies, specialty drug management (including a cost-plus specialty pharmacy), claims adjudication, pharmacy network management, and member enablement and support services. Navitus positions itself as a fiduciary partner focused on affordability, compliance, clinical quality and improving health outcomes through tailored PBM services and digital health integrations.

📋 Description

• Follow standard operating procedures to obtain and process manufacturer copay assistance program reimbursement • Monitor claims activity for accuracy and successful submission • Ensure patient billing information is set up appropriately in pharmacy software • Participate in conferences and meetings related to reimbursement/billing • Respond to employee, patient, and client questions or complaints regarding reimbursement and/or billing • Work with internal teams to review and resolve claim issues • Maintain accurate reference information relating to reimbursement and copay assistance • Document information, insurance, and prescriptions/orders accurately and thoroughly within patient profiles • Act in accordance with applicable federal and state laws and the highest ethical standards • Perform other duties as assigned

🎯 Requirements

• High School Diploma or equivalent GED • Some college preferred • CPhT preferred • Pharmacy technician license or pharmacy technician trainee license is strongly preferred in states requiring pharmacy technician licensure • Experience with pharmacy, health plan or clinical insurance claims billing, benefit assessments, billing/claims documentation, or claims auditing is preferred • Participate in, adhere to, and support compliance program objectives • The ability to consistently interact cooperatively and respectfully with other employees • Remote work is unavailable to residents of Alaska, Connecticut, Delaware, Hawaii, Idaho, Kansas, Kentucky, Maine, Massachusetts, Mississippi, Montana, New Hampshire, New Mexico, North Dakota, Rhode Island, South Carolina, South Dakota, Vermont, Washington DC, West Virginia, and Wyoming

🏖️ Benefits

• 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! • M-F 10:30AM-7PM schedule