Senior Drug Rebate Analyst
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Job Description
Senior Drug Rebate Analyst reviewing Medicaid Drug Rebate payments while resolving disputes. Involves ensuring compliance, training new hires, and engaging with pharmacy and drug manufacturers.
Responsibilities:
- Reviews Medicaid Drug Rebate payments from drug manufacturers to identify rebate disputes and resolve outstanding balances
- Contact pharmacy and medical providers to verify claims data
- Contact drug manufacturers for information on disputed rebates
- Provide training for new hires and act as a subject matter expert to team
- Assist in required CMS reporting and invoicing as needed
- Act as backup for Drug Rebate Supervisor tasks as needed
- Assist the Supervisor in monitoring dispute workflow
- Lead efforts to focus efforts on the highest materiality disputes
- Assist with claim load file quality validation
- Research disputed pharmaceutical utilization to prepare dispute resolution proposals
- Negotiate with drug manufacturers to resolve disputes fairly and accurately
- Complete required productivity tracking reports
- Track and prioritize dispute resolution activities on an ongoing basis
- Review and resolve invoices in assigned workflow queues on a daily basis
- Follow up with drug manufacturers to secure payment for unpaid invoices
- Interact with internal and external customers to accomplish goals
- Other tasks as directed
Requirements:
- 5+ years’ experience with Medicaid Drug Rebates, Medical/Pharmacy claims processing, Pharmacy and/or medical billing is highly preferred
- Drug Rebate system experience such as PRIMS, SSRS Reports, Process Manager, or other drug rebate systems
- MS Office Suite, PDF Editing Software (Adobe, Nitro Pro, PDF Escape)
- Ability to work in a paper free environment
- Excellent organizational skills
- Excellent verbal and written communication skills
Benefits:
- generous, flexible vacation policy
- educational assistance
- comprehensive health benefits
- 401(k) employer match
- leadership and technical development academies
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