(Remote – U.S. Based*)
🧾 About the Role
Navitus is looking for a Manual Claims Coordinator to process complex pharmacy and direct member reimbursement (DMR) claims. This role sits at the crossroads of customer service, pharmacy operations, and technical benefit management. You’ll help ensure claims are processed accurately and efficiently while supporting audits, regulatory compliance, and client satisfaction.
✅ Position Highlights
• $18.67–$21.96/hour
• Full-time, remote (with some state restrictions*)
• Monday–Friday, 8:00 AM – 5:00 PM
• Top-tier health, dental, and vision benefits
• 20 days PTO + 9 paid holidays
• 4 weeks paid parental leave
• 401(k) with 5% company match (no vesting requirement)
• Adoption and education assistance
• Flexible Spending Account
📋 What You’ll Own
• Process pharmacy and DMR claims across varying levels of complexity
• Interpret plan designs and client-specific rules to ensure accuracy
• Handle intake and categorization of mail, and manage outgoing member/pharmacy letters
• Batch and verify large claim uploads
• Participate in audits, create audit reports, and answer audit-related inquiries
• Support implementations and changes for low to moderately complex clients
• Collaborate across departments including Member Services, Clinical, Client Services, and more
• Draft and maintain training materials, documentation, and internal workflows
• Assist in identifying root causes and recommending process improvements
• Support weekend or after-hours work as needed
🎯 Must-Have Traits
• Associate’s degree or equivalent work experience
• Some prior claims, customer service, or pharmacy-related experience is helpful
• Proficiency with Microsoft Word and Excel
• Willingness to learn internal systems, policies, and benefit designs
• Detail-oriented and organized, with strong communication skills
• Able to work across teams and manage competing priorities
💻 Remote Requirements
• Must reside in the U.S.
• Navitus does not hire remote workers in: AK, HI, ME, MS, NH, NM, ND, RI, SC, SD, WV, or WY
• Stable internet and distraction-free workspace
💡 Why It’s a Win for Remote Job Seekers
• You’ll help members receive fair and timely claim reimbursements
• Opportunity to build pharmacy operations knowledge
• Solid entry point into the PBM industry
• Excellent benefits, great team, meaningful work
✍️ Call to Action
If you’re detail-driven, eager to grow, and ready to support fair access to medications, apply now. Join a team committed to people-first pharmacy.