Medicaid Claims Analyst Position

5 days ago


Parsippany, New Jersey, United States Sunrise Systems, Inc. Full time
Job Title: Medicaid Claims Analyst

Job Summary:

We are seeking a highly skilled Medicaid Claims Analyst to join our team at Sunrise Systems, Inc. The successful candidate will be responsible for analyzing and resolving complex Medicaid claims, ensuring compliance with CMS guidelines and state-specific regulations.

Key Responsibilities:

  • Validate and verify Medicaid claims to ensure accuracy and completeness
  • Dispute and resolve claims that require additional information or clarification
  • Collaborate with state agencies and pharmaceutical companies to resolve rebate-related issues
  • Develop and maintain knowledge of Medicaid regulations and guidelines
  • Provide exceptional customer service to internal and external stakeholders

Requirements:

  • Bachelor's degree in a related field, such as healthcare or business
  • Minimum 2+ years of experience in Medicaid claim processing or a related field
  • Strong analytical and problem-solving skills
  • Excellent communication and interpersonal skills
  • Ability to work in a fast-paced environment and meet deadlines

Preferred Qualifications:

  • Experience with Medicaid rebate systems and government pricing regulations
  • Knowledge of pharmaceutical industry practices and regulations
  • Certifications in Medicaid claim processing or a related field

What We Offer:

  • A competitive salary and benefits package
  • Opportunities for professional growth and development
  • A dynamic and supportive work environment


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