Senior Drug Rebate Analyst

Gainwell Technologies LLCAny city, OH
$51,700 - $73,800Remote

About The Position

Reviews Medicaid Drug Rebate payments from drug manufacturers to identify rebate disputes and resolve outstanding balances.

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

Responsibilities

  • 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

Benefits

  • Work flexibility
  • Learning
  • Career development
  • Technical credentials and certifications
  • Generous, flexible vacation policy
  • Educational assistance
  • Comprehensive leadership and technical development academies
  • 401(k) employer match
  • Comprehensive health benefits
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