Reimbursement Specialist I (10:30-7:00pm CST)

Navitus Health Solutions, LLCNavitus Health Solutions, LLCUnited States
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Posted

10/10/2026

Employment

Full time

Range

$19 - $22/hr

Work style

Remote OK

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AI summary

Core responsibilities

The Reimbursement Specialist I is responsible for processing manufacturer copay assistance program reimbursements and monitoring claims activity for accuracy. They also manage patient billing information and resolve claim issues while maintaining compliance with federal and state laws.

Requirements overview

Candidates must have a high school diploma or equivalent, with some college preferred. A pharmacy technician license or trainee license is strongly preferred, along with experience in pharmacy or health insurance claims billing.

Key skills

ReimbursementBilling proceduresClaims processingPharmacy softwareInsurance claimsBenefit assessmentsClaims auditingDocumentationComplianceCommunicationData entryCustomer service

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Education requirements

high school

About Navitus Health Solutions, LLC

Industry

Hospitals and Health Care

Employees

1,755

Type

Privately Held

Size

1,001-5,000 employees

Navitus Health Solutions is a pioneering pharmacy solutions provider, having launched one of the first transparent PBMs over 20 years ago. Unlike traditional PBMs that profit from opaque pricing, Navitus passes 100% of negotiated rebates and discounts directly to health plans and plan sponsors. Its clinical model is built to manage spend from the start, making key decisions that support member health while lowering costs. This in turn drives both immediate value and long-term savings, by managing trend over time. Navitus Health Solutions delivers a range of services through portfolio brands including Navitus, Lumicera and Archimedes. Owned by SSM Health and Costco Wholesale Corporation, the company serves over 18 million members across 800 clients, including public and private sector employers, unions, health plans and health systems. For more information, please visit www.navitus.com.

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Job categories

HealthcareAdministrativeFinance & AccountingCustomer Service & Support

Description

Company Lumicera Work Schedule Description (e.g. M-F 8am to 5pm) M-F 10:30AM-7PM Remote Work Notification ATTENTION: Lumicera is only able to offer remote work to residents of Arizona, Alabama, Arkansas, California, Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Louisiana, Maryland, Michigan, Minnesota, Missouri, Nebraska, Nevada, New Jersey, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Tennessee, Texas, Utah, Virginia, Washington, Wisconsin Hiring Manager : Full Name: First Last Kristine Frye Overview Lumicera Health Services is seeking a Reimbursement Specialist I to join our team! Under direction from the Assoc. Manager, Specialty Pharmacy Services, Reimbursement Team Lead, and pharmacists in the Specialty Pharmacy, the Reimbursement Specialist I is primarily responsible for following standard operating procedures to obtain and process manufacturer copay assistance program reimbursement. The Reimbursement Specialist I shall have knowledge of billing procedures and work to reduce discrepancies, inaccuracy, and outstanding balances. The Reimbursement Specialist I may also assist in contacting patients with an outstanding balance to communicate billing options. Is this you? Find out more below! Responsibilities How do I make an impact on my team? Responsible for ongoing monitoring of claims activity for accuracy and successful submission Responsible for ensuring that patient billing information is set up appropriately in the pharmacy software Participate, as necessary, in conferences and meetings related to reimbursement/billing Responds to employee/patient/client questions or complaints regarding reimbursement and/or billing Works with internal teams to review and resolve claim issues Maintains accurate reference information relating to reimbursement and copay assistance Responsible for accurate and thorough documentation of information, insurance and prescriptions/orders within the patient profile The Employee will act in accordance with all applicable federal and state laws and with the highest ethical standards that we consistently strive to achieve. Thus, legal and ethical compliance is an essential duty of each employee Other duties as assigned Qualifications What our team expects from you? 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 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! #LI-Remote Pay Range USD $18.67 - USD $21.96 /Yr.

Requirements

  • •Reimbursement
  • •Billing procedures
  • •Claims processing
  • •Pharmacy software
  • •Insurance claims
  • •Benefit assessments
  • •Claims auditing
  • •Documentation
  • •Compliance
  • •Communication
  • •Data entry
  • •Customer service

Benefits

  • •Health insurance
  • •Dental insurance
  • •Vision insurance
  • •Paid time off
  • •Paid parental leave
  • •Paid holidays
  • •401k company match
  • •Adoption assistance program
  • •Flexible spending account
  • •Educational assistance plan
  • •Professional membership assistance
  • •Referral bonus program

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