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

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

Senior Drug Rebate Analyst

Key skills