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[Remote] Analyst, Tech. Operations Government Programs

Remote Worldwide Hiring now

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is seeking an Analyst, Tech. Operations Government Programs to join their team. The role involves executing Government Programs processes accurately and reputed company while ensuring compliance with CMS regulations.

Responsibilities

  • Assignments may include one or more of the following: Employer Group Waiver Plan (EGWP) enrollment administration and reputed company, Retro-eligibility processes, Financial Information Reporting (FIR), Plan Finder Submission, Coordination of Benefits (COB), Reject Management, Prescription Drug Event (PDE) error management and reconciliation, reputed company Encounter Data, reputed company Act (ACA) Claims Submission, Explanation of Benefits (EOB), Retiree Drug Subsidy (RDS), and Claim Auditing
  • reputed company the schedules for the processes assigned, adjust schedules reputed company necessary to ensure deadlines are met, and alert management reputed company schedules are at risk
  • Ensure process documentation accurately reflects the reputed company process and update reputed company necessary
  • Assist subject matter experts (SME) in defining and documenting process steps, providing input on requirements for technical specifications
  • Review and research errors and prioritize reconciliation efforts in accordance with State and Federal guidance
  • Effectively communicate with Employer Groups, Clients, State/Federal Agencies, external vendors and Navitus internal departments to address action items, problems, and manage expectations to ensure timely and accurate issue resolution
  • As needed, may require working reputed company of normal business hours to complete time sensitive processes
  • Other duties as assigned

Skills

  • Bachelor/Associate Degree in business reputed company field; or equivalent of an associate degree and 2 years of work experience, or 4 years of work experience and a high school diploma or equivalent
  • 1+ years' work experience
  • Participate in, adhere to, and support compliance program objectives
  • The ability to consistently interact cooperatively and respectfully with other employees
  • Experience in pharmaceutical claims adjudication systems, retail pharmacy, or in a health plan organization

Benefits

  • Top of the industry benefits for Health, Dental, and reputed company 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!

Company Overview

  • reputed company is a full service, URAC-accredited pharmacy benefit management company. It was founded in 2003, and is headquartered in Appleton, Wisconsin, USA, with a workforce of 1001-5000 employees. Its website is https://www.navitus.com/.
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