Coordinator, Accumulator

Navitus Health Solutions is seeking a Accumulator Coordinator to join our team!

The Coordinator, Accumulator ensures efforts are in alignment with the Claim Adjudication Operations (CAO) team to leverage technology and process improvement for the purpose of meeting the business needs of Navitus customers, clients, members, and pharmacies by accurately administering benefits. This role is responsible for the ongoing management of client accumulator processes and will function as the lead accumulator resource for assigned clients, as well as a back-up resource for peer coordinators when needed.

The Coordinator, Accumulator requires knowledge of both the technical and operational sides of the business. This position will work closely with Information Technology, Benefit Configuration, Eligibility, and Client Services teams to understand the interdependences of each functional area. The Coordinator, Accumulator will have direct authority to make sound business decisions regarding client accumulator data and will demonstrate the ability to continually prioritize day to day workload to meet individual, departmental, and organizational goals.

This position may include after-hour and/or weekend hours depending on workload.

Is this you? Find out more below!

How do I make an impact on my team?

Oversees, manages, and maintains accumulator data, processes and services for clients of low to moderate complexity. This includes understanding client needs, plan designs, monitoring of electronic file loads and subsequent reports and any additional accumulator related processes.
• Performs accumulator updates timely and accurately to prevent member access to care issues, missed performance guarantees and potential liquidated damages.
• Works directly with client contacts and supports internal customers by participating in client meetings, audits and new program implementations with other areas of the company, answering accumulator questions and providing guidance to other areas and roles on accumulator processes.
• Requests, validates and confirms full file data feeds from clients to ensure system integrity through audits and reconciliation.
• Collaborates directly with client and/or Client Services team to report data file errors and accumulator reconciliation results on an agreed upon client schedule.
• Independently assesses business needs and participates in process improvement, cost reduction and automation efforts.
• Uses sound business judgment and expertise to contribute toward the creation of root cause analysis of issues.
• Educates others on the accumulator process, providing talking points for Member Services to explain accumulators to members and pharmacies, and to Client Services and Government Programs to explain corrective outcomes.
• Adapts to industry changes and evolving technology, maintaining a basic to intermediate level of understanding of both legacy and emerging products and systems.
• Conducts system enhancement and regression testing of a low to moderate level of complexity for accumulator related processes to ensure compliance with state, federal and client regulations/standards.
• Assists in the creation and ongoing maintenance of departmental training materials, work instructions and policies.
• Participate in, adhere to and support compliance and diversity, equity, and inclusion program objectives.
• Other duties as assigned.

What our team expects from you?

• Education: Associate's degree or equivalent work experience required.
• Experience:
  • Minimal experience and/or training to begin learning skills, systems, and processes of the role with ability to perform tasks with close supervision.
  • Basic experience with Microsoft Office, specifically Word and Excel.

What can you expect from Navitus?

• 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!