Job Profile
- Process claims and Resubmissions: The analyst analyzes and validates all lines for assigned customer accounts. The analyst is responsible for identifying the root cause of issues with discrepancies and taking corrective action to eliminate future occurrences and reduce the outstanding wholesaler chargeback deduction balance.
- The analyst is responsible for researching chargeback rejections due to invalid data. The incumbent works with wholesalers and internal contract/membership groups to resolve issues for problematic chargebacks including errors associated with pricing membership eligibility dating and claims data.
- The analyst will also perform ad hoc reports and projects as required. Performs Daily and Monthly Reconciliations
- To ensure completeness The analyst will perform a daily and monthly reconciliation of inbound chargebacks to the EDI 844 transmission. The analyst also performs a daily reconciliation of outbound chargebacks to the EDI 849 transmission.
- Interact with Internal and External Customers: The Chargeback analyst responds to wholesaler inquiries. as well as works with the Contracted Entities to resolve pricing or membership questions and discrepancies. The analyst also works cross-functionally as required to research and resolve issues.
Qualifications :
Skills Set
- Ensures on time and high-quality delivery of assigned claims/contracts
- Creates/Distributes supporting documentation to clients/states/customers
- Creates Ad hoc Reports as requested
- Researches resolves and documents disputes trends and calculation variances
- Ensure compliance with all contract terms
- Maintains tracking logs
- Retrieves customer and sales data for Chargeback/rebate/Admin fee processing
- Supports audit requests as assigned
Prerequisite
- 1 year related experience preferred
- Strong analytical skills
- Strong verbal written and interactive skills with both internal and external stakeholders
- Advanced PC skills required
- Advanced skills in Microsoft Excel required
- Ability to work independently and with a team
- Ability to perform under tight deadlines and balance multiple clients deliverables
- Strong attention to detail required
- Strong organization and prioritization sills required
- Ability to learn new technology quickly
- Pharmaceutical or Healthcare Industry knowledge a plus Model N Flex or Model N a plus
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Additional Information :
What does IntegriChain have to offer
- Mission driven: Work with the purpose of helping to improve patients lives!
- Excellent and affordable medical benefits non-medical perks including Flexible Paid Time Off
- Robust Learning & Development opportunities including over 700 development courses free to all employees
IntegriChain is committed to equal treatment and opportunity in all aspects of recruitment selection and employment without regard to race color religion national origin ethnicity age sex marital status physical or mental disability gender identity sexual orientation veteran or military status or any other category protected under the law. IntegriChain is an equal opportunity employer; committed to creating a community of inclusion and an environment free from discrimination harassment and retaliation.
Remote Work :
No
Employment Type :
Full-time