N

Navitus Health Solutions

Transparent PBM pass-through rebates for plans

Reimbursement Specialist I - 7:00pm CST

Clinical Support & Patient AdministrationUpdated on Nov 10
Full-timeRemote in USA$18.67 - $21.96 /yr

About the Job

Requirements

  • A high school diploma or equivalent GED is required.
  • A pharmacy technician certification is preferred.
  • A 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 or claims documentation, or claims auditing is preferred.
  • Participate in, adhere to, and support compliance program objectives.
  • Consistently interact cooperatively and respectfully with other employees.

Responsibilities

  • Monitor claims activity on an ongoing basis for accuracy and successful submission.
  • Ensure patient billing information is set up appropriately in the pharmacy software.
  • Participate, as necessary, in conferences and meetings related to reimbursement and billing.
  • Respond to employee, patient, and client questions or complaints regarding reimbursement or billing.
  • Work with internal teams to review and resolve claim issues.
  • Maintain accurate reference information relating to reimbursement and copay assistance.
  • Accurately and thoroughly document information, insurance, and prescriptions or orders within the patient profile.
  • Act in accordance with applicable federal and state laws and the organization's ethical standards; legal and ethical compliance is an essential duty.
  • Perform other duties as assigned.

Desired Qualifications

  • Some college is preferred.

About the Company

Navitus Health Solutions

Transparent PBM pass-through rebates for plans

Navitus Health Solutions is a pharmacy benefits manager that offers transparent pricing by passing 100% of negotiated rebates and discounts to its health-plan clients. It runs a spend-management clinical model designed to control drug costs from the outset while supporting member health, delivering both immediate value and long-term savings as drug spend trends are managed over time. The company markets its services through its portfolio brands—Navitus, Lumicera, and Archimedes—and serves over 18 million members across 800 clients, including public and private employers, unions, health plans, and health systems. It is owned by SSM Health and Costco Wholesale Corporation. Unlike traditional PBMs with opaque pricing, Navitus emphasizes transparency and direct savings for plan sponsors. The overarching goal is to reduce prescription drug costs for plans while improving member health outcomes.

Company size
1,001-5,000
Company stage
Not listed
Total funding
Not listed
Headquarters
Appleton, WI
Founded
2003

Recently Posted Jobs

Explore more opportunities at Navitus Health Solutions

See more jobs