SmithRx

Rebate Operations Manager

SmithRx

full-time

Posted on:

Location Type: Remote

Location: United States

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About the role

  • Oversee initial claims file submissions and conduct comprehensive QA summaries to identify potential fallouts before submission.
  • Manage rejections from external partners; perform root-cause analysis on data issues and re-submit corrected claims to maximize capture.
  • Monitor and "push" for the billing of claims missed during initial windows due to vendor delays or data gaps, ensuring no revenue is left on the table.
  • Build and maintain master rate lists based on current formularies and utilization management (UM) to correspond with product-specific rates.
  • Marry billed amounts back to rate lists to identify missing, incorrect, or inappropriately billed amounts.
  • Verify incoming payments against invoiced amounts; identify and dispute short-payments or missing funds.
  • Build out rebate performance reports.
  • Run monthly "pro-forma" estimates of expected rebates to serve as a benchmark for actual collections.
  • Manage and optimize the internal dashboards to provide "slice-and-dice" visibility into rebate trends for executive leadership and sales teams.

Requirements

  • Bachelor’s Degree: Finance, Accounting, Data Analytics, Economics, or Business Administration.
  • Minimum of 2 years of direct experience with a GPO or similar rebate aggregators/aggregating platforms is highly preferred.
  • Proficiency in managing large data sets at the NDC-11 level. Advanced Excel is required.
  • Strong understanding of the "reconciliation loop" connecting initial claims to invoices, and invoices to actual cash received
  • A proven ability to track "Stale Billing" and "Post-Billing Rejects" through to resolution.
  • Proven knowledge of pharmacy benefit management practices, including UM and clinical program design.
Benefits
  • Highly competitive wellness benefits including Medical, Pharmacy, Dental, Vision, and Life Insurance and AD&D Insurance
  • Flexible Spending Benefits
  • 401(k) Retirement Savings Program
  • Short-term and long-term disability
  • Discretionary Paid Time Off
  • Paid Company Holidays
  • Wellness Benefits
  • Commuter Benefits
  • Paid Parental Leave benefits
  • Employee Assistance Program (EAP)
  • Well-stocked kitchen in office locations
  • Professional development and training opportunities
Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools
data analysisroot-cause analysisQA summariesreconciliationExceldata managementreportingbillingclaims processingfinancial analysis
Soft Skills
attention to detailproblem-solvingcommunicationorganizational skillsleadershipcollaborationanalytical thinkingtime managementadaptabilitycritical thinking