משרות תוצאות חיפוש מתאימות לבקשתך:

The opportunity
The Medicaid Claims Analyst is responsible for Medicaid Drug Rebate process which includes validating, verifying, disputing when necessary, and remitting payment for assigned state Medicaid agencies, SPAPs and Supplemental Rebates.  Analyst is accountable for submitting payments within deadlines and in compliance with CMS guidelines and Teva rebate contract terms. This position also provides assistance in resolving dispute resolution, weekly pay run activities, SOX audits, system upgrade/implementation and ad hoc analysis. 
How you’ll spend your day
Work with assigned states to get Medicaid Summary invoice, summary data file and Claim Level Invoice each quarter and review to ensure completeness of information received. Upload data into Medicaid systems and authorize transactions. Document errors and perform research.
Conduct initial quality check on summary data on all claim submissions to ensure rebate eligibility and data consistency.
Perform Claim Level Detail validation. Review suspect claim records and determines if record should be disputed for payment.  
Resolve disputes and propose recommended amounts to be paid for historical outstanding utilization that is routinely submitted with Medicaid claims. Must have ability to work independently and make recommendation on state disputes, apply proper amounts to be paid & ensure CMS codes are applied correctly; notify states of results/findings.
Complete Medicaid analyzes and documentation on assigned states/programs.  Communicate to manager for key findings and changes to state programs. 
Provide backup for Medicaid team members in any necessary functions and work with team to establish best practices within Teva Medicaid work environment.