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Senior Drug Rebate Analyst
Gainwell TechnologiesSenior Drug Rebate Analyst reviewing Medicaid Drug Rebate payments while resolving disputes. Involves ensuring compliance, training new hires, and engaging with pharmacy and drug manufacturers.
About the role
Key responsibilities & impact- 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
What you’ll need- 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
Comp & perks- generous, flexible vacation policy
- educational assistance
- comprehensive health benefits
- 401(k) employer match
- leadership and technical development academies
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
Medicaid Drug RebatesMedical claims processingPharmacy claims processingMedical billingDispute resolutionProductivity trackingQuality validationNegotiation
Soft Skills
Organizational skillsVerbal communicationWritten communicationTrainingTeam collaboration