(Remote – U.S. Based*)
🧾 About the Role
Navitus is hiring a Manual Claims Coordinator to process complex pharmacy and direct member reimbursement (DMR) claims. This role blends customer service, pharmacy benefit operations, and audit support to help ensure accurate and timely claims processing—all while improving member experiences and supporting compliance.
✅ Position Highlights
• Pay: $18.67–$21.96/hour
• Employment Type: Full-Time
• Schedule: Monday–Friday, 8 AM – 5 PM
• Location: Remote (some state exclusions*)
• Benefits: Top-tier medical, dental, vision, 20 PTO days, 9 holidays, 4 weeks paid parental leave, 401(k) with 5% match, education/adoption support, FSAs
*Navitus does not hire remote workers in: AK, HI, ME, MS, NH, NM, ND, RI, SC, SD, WV, or WY
📋 What You’ll Own
• Process complex pharmacy and DMR claims
• Interpret plan designs and client-specific rules
• Manage claim-related mail, letters, and documentation
• Verify and batch large claim uploads
• Support internal audits and prepare audit documentation
• Collaborate with Member Services, Clinical, and Client Services
• Create and update training documents and workflows
• Assist with root cause analysis and recommend improvements
• Support implementations for low/moderate complexity clients
• Occasionally support after-hours or weekend work
🎯 Must-Have Traits
• Associate’s degree or equivalent experience
• Familiarity with claims, pharmacy, or customer service preferred
• Detail-oriented with strong organizational and communication skills
• Proficient in Microsoft Word and Excel
• Eager to learn benefit designs and internal systems
• Able to juggle priorities and work across departments
💻 Remote Requirements
• U.S. residency required (see state restrictions above)
• Distraction-free home office with reliable internet
💡 Why It’s a Win for Remote Job Seekers
• Strong benefits with a people-first culture
• Entry point into the pharmacy benefit management (PBM) space
• Work with a mission-driven team focused on access and accuracy
• Opportunities for growth in operations, audit, and member services
✍️ Call to Action
If you’re process-driven, love solving problems, and want to help ensure people receive fair and timely access to medications, this might be your next role. Apply now and bring your precision to a company that puts members first.