Remote Drug Rebate Analyst for Medicaid Payments

RemoteFetch; West Virginia; Remote; USD 36,000 - 51,000; Full time

Benefits offered by this job

Medical, dental, vision coverage

401(k) retirement plan

Job summary

Gainwell Technologies is seeking a Drug Rebate Analyst to support Medicaid pharmacy operations by reviewing rebate payments, researching disputed claims, and resolving outstanding rebate balances. This remote role collaborates with drug manufacturers, pharmacies, providers, and internal partners to investigate discrepancies and ensure timely collection of rebates.

The role requires experience in Medicaid rebates, claims processing, and related healthcare settings, with strong analytical and

Qualifications

• Experience with Medicaid Drug Rebates, pharmaceutical rebates, medical or pharmacy claims processing, pharmacy operations, medical billing, or a related healthcare environment is highly preferred.
• Strong analytical, research, and critical-thinking skills with the ability to investigate claims, utilization, payment, and invoice discrepancies.
• Experience with PRIMS, SSRS Reports, Process Manager, or similar drug rebate, claims, reporting, or workflow systems is preferred.
• Proficiency with Microsoft Office and electronic documentation/PDF applications, with the ability to work effectively in a paperless environment.
• Bachelor's degree in business or a related field, or equivalent relevant professional experience, preferred; strong organizational, written and verbal communication skills and the ability to maintain HIPAA confidentiality are required.

Responsibilities

• Review Medicaid drug rebate payments, invoices, and outstanding balances to identify discrepancies and support timely resolution.
• Research disputed pharmaceutical utilization and claims data and develop accurate rebate dispute resolution recommendations.
• Communicate and negotiate with drug manufacturers to resolve rebate disputes and follow up on unpaid or outstanding invoices.
• Work with pharmacies, medical providers, and internal partners to verify claims information and obtain documentation needed to research and resolve discrepancies.
• Track and prioritize dispute-resolution activities, manage assigned workflow queues, maintain accurate records, and complete required productivity reporting.

Skills

Medicaid Drug Rebates

pharmaceutical rebates

claims processing

pharmacy operations

HIPAA compliance

Education

Bachelor's degree in business or related field

Tools

PRIMS

SSRS Reports

Process Manager

Job description

Gainwell Technologies is seeking a Drug Rebate Analyst to support Medicaid pharmacy operations by reviewing rebate payments, researching disputed claims, and resolving outstanding rebate balances. This remote role collaborates with drug manufacturers, pharmacies, providers, and internal partners to investigate discrepancies and ensure timely collection of rebates.

The role requires experience in Medicaid rebates, claims processing, and related healthcare settings, with strong analytical and