Senior Drug Rebate Analyst

🕒 Junho 15

🤠 Texas – Remoto

🤠 Texas – Remote

💵 $51.700 - $73.800 / ano

⏰ Tempo Integral

🟠 Sênior

🧐 Analista

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Gainwell Technologies

SiteLinkedInTodas as Vagas

10.000+ funcionários

⚕️ Seguro de Saúde

💰 Grant em 2023-06

Healthcare Insurance • Human Services • Healthcare

A Gainwell Technologies é a principal provedora do país de soluções digitais e cloud-enabled em todo o ecossistema de serviços humanos e saúde pública. Com uma abordagem orientada por propósito, a Gainwell atende clientes nos 50 estados dos EUA, com foco em melhorar os desfechos em saúde e oferecer experiências intuitivas e centradas nas pessoas. Seu portfólio abrangente inclui modernização do Medicaid Enterprise, data analytics, serviços para prestadores e soluções para farmácia — tudo projetado para impulsionar o futuro da saúde e promover o bem-estar das comunidades.

Descrição

• 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

🎯 Requisitos

• 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

🏖️ Benefícios

• generous, flexible vacation policy • educational assistance • comprehensive health benefits • 401(k) employer match • leadership and technical development academies