Remote Analyst Medicaid Operations (Marlborough, MA)

Remote Analyst Medicaid Operations

Remote Analyst Medicaid Operations needs 5 year(s) experienceRemote Analyst Medicaid Operations requires Work on EST time zone. Revitas Flex Model N or other similar industry standard software is the best 5 plus years and mid level role. Bachelor s degree or equivalent experience Four or more years of experience processing rebate claims within pharmaceutical industry Advanced knowledge of and experience with common industry software programs (i.e. CARS IS Classic and Revitas Flex Model N or other similar industry standard software). Keen attention to detail Able to investigate analyze information and resolve business questions by applying information from various data sources business rules and system processes Solid knowledge of pharmaceutical product contract agreements and the Medicaid Regulatory environment Advanced knowledge of Microsoft Excel and other Microsoft programs Remote Analyst Medicaid Operations duties Processes the more complex Medicaid State MCO & SPAP rebate payments using the Revitas software application or other similar industry standard software Responsible for calculating Medicaid Unit Rebate Amounts (URA s) for all Products Reviews contact language and sets up all Medicaid contracts in contract system Responsible for set up and testing of any new payment formulas needed to support creative contract language or regulatory changes Requests and reviews claim level detail to support quarterly Medicaid invoices. Analyzes data for anomalies and initiates disputes with states where warranted Investigates analyzes information and resolves business questions and disputes by applying information from various data sources business rules and system processes Fosters and maintains constructive working relationships over the telephone with State contacts and invoice intermediaries while resolving business issues dealing with invoicing and data inaccuracies. Able to communicate and resolve discrepancies with customers in these situations while maintaining positive relationships and professionalism Performs detailed analytics on invoice data and communicates unusual invoicing activity to management and internal stakeholders Maintains service standards in processing data and proactively advises management of issues Maintains status reports and updates numerical information in spreadsheets Able to identify issues and recommend improvements in business procedures for increased efficiency without compromising integrity of data Serves as project lead in all systems testing trouble shooting and system enhancement recommendations Initiates and leads ad-hoc analyses and projects needed for decision-making and feedback Serves as a trusted advisor shares knowledge and conducts peer-to-peer training sessions on Medicaid invoice processing and dispute resolution with internal external partners Oversees dispute review efforts and processing of less experienced analysts