Drug Rebate Team Lead

2 weeks ago


Madison, Wisconsin, United States Gainwell Technologies LLC Full time
Summary

Reviews WI Medicaid Drug Rebate payments from drug manufacturers to identify rebate disputes and resolve outstanding balances.
Your role in our mission

o Contact pharmacy and medical providers to verify claims data

o Contact drug manufacturers for information on disputed rebates

o Provide training to new hires and act as a subject matter expert to team

o Assist in required CMS reporting and invoicing as needed

o Act as backup for Drug Rebate Manager tasks as needed

o Assist the Manager in monitoring dispute workflow

o Lead efforts to focus efforts on the highest materiality disputes

o Assist with claim quality validation

o Research disputed pharmaceutical utilization to prepare dispute resolution proposals

o Negotiate with drug manufacturers to resolve disputes fairly and accurately

o Complete required productivity tracking reports

o Track and prioritize dispute resolution activities on an ongoing basis

o Follow up with drug manufacturers to secure payment for unpaid invoices

o Interact with internal and external customers to accomplish goals

o other tasks as directed
What we're looking for

o Drug Rebate system experience

o MS Office Suite, PDF Editing Software (Adobe, Nitro Pro, PDF Escape)

o Ability to work in a paper free environment

o Excellent organizational skills

o Excellent verbal and written communication skills

o Strong analytical and critical thinking skills

o Maintain regular attendance based on agreed-upon schedule

o Experience with Medicaid drug rebates, Medical/Pharmacy claims processing, Pharmacy, and/or medical billing is highly preferred

o Maintain confidentiality and comply with the Health Insurance Portability and Accountability Act (HIPAA)

o Ability to establish and maintain positive and collaborative work relationships with coworkers, clients, providers, and customers
What you should expect in this role

o Bachelor's Degree or equivalent experience, preferably in business or a related field

o 5-10 years' experience with Medicaid Drug Rebates, Medical/Pharmacy claims processing, Pharmacy and/or medical billing is highly preferred

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