Senior Drug Rebate Analyst

🔥 1 minute ago

🤠 Texas – Remote

🤠 Texas – Remote

💵 $51.7k - $73.8k / year

⏰ Full Time

🟠 Senior

🧐 Analyst

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Gainwell Technologies

WebsiteLinkedInAll Job Openings

10,000+ employees

⚕️ Healthcare Insurance

💰 Grant on 2023-06

Healthcare Insurance • Human Services • Healthcare

Gainwell Technologies is the nation’s leading provider of digital and cloud-enabled solutions across the human services and public health ecosystem. With a mission-driven approach, Gainwell serves clients in all 50 U. S. states, focusing on improving health outcomes and delivering intuitive, human-centered experiences. Their comprehensive suite of solutions includes Medicaid Enterprise modernization, data analytics, provider services, and pharmacy solutions, all designed to advance the future of healthcare and enhance community well-being.

📋 Description

• 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