Drug Rebate Team Lead
2 weeks ago
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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