Senior Drug Rebate Analyst

This is a fully remote position, open to applicants in Texas.

📋 Description

• Examines Medicaid Drug Rebate payments from pharmaceutical manufacturers to identify rebate disputes and resolve pending balances.

• Communicates with pharmacy and medical providers to confirm claims data.

• Reaches out to drug manufacturers for information regarding disputed rebates.

• Provides training for new employees and serves as a subject matter expert for the team.

• Assists with necessary CMS reporting and invoicing as required.

• Acts as a backup for Drug Rebate Supervisor responsibilities when needed.

• Supports the Supervisor in overseeing the dispute workflow.

• Leads initiatives to concentrate efforts on the most significant materiality disputes.

• Aids in validating the quality of claim load files.

• Investigates disputed pharmaceutical usage to prepare proposals for dispute resolution.

• Engages in negotiations with drug manufacturers to resolve disputes fairly and accurately.

• Completes necessary productivity tracking reports.

• Monitors and prioritizes dispute resolution activities on an ongoing basis.

• Reviews and resolves invoices in assigned workflow queues on a daily basis.

• Follows up with drug manufacturers to ensure payment for outstanding invoices.

• Interacts with both internal and external clients to achieve objectives.

• Performs additional tasks as assigned.

⛳️ Requirements

• A minimum of 5 years’ experience in Medicaid Drug Rebates, Medical/Pharmacy claims processing, or Pharmacy and/or medical billing is highly preferred.

• Familiarity with Drug Rebate systems such as PRIMS, SSRS Reports, Process Manager, or other related systems.

• Proficiency in MS Office Suite and PDF Editing Software (Adobe, Nitro Pro, PDF Escape).

• Ability to work effectively in a paperless environment.

• Exceptional organizational skills.

• Strong verbal and written communication abilities.

🏝️ Benefits

• Generous and flexible vacation policy.

• Educational assistance.

• Comprehensive health benefits.

• 401(k) employer match.

• Leadership and technical development academies.