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The future of payment integrity.
High-Cost Drug Analyst
Location
United States
Posted
36 days ago
Salary
$47K / year
Seniority
Senior
Job Description
High-Cost Drug Analyst
Machinify
• Investigates to confirm that drug claims are billed and paid correctly • Analyzes claims data and healthcare records, applying specialized knowledge of prescription drugs, provider practices, and health insurance benefit structure • Communicates with healthcare providers and insurers to gather required information • Utilizes all available resources to maximize identification and recovery of overpayments • Answers phone calls in a timely fashion and resolves issues • Creates, maintains, and closes files in accordance with policies and guidelines • Assists with submitting overpaid claims in client vendor management systems, as needed
Job Requirements
- Bachelor’s Degree or equivalent combination of experience in health insurance or related fields, which would provide the necessary knowledge, skills and abilities to successfully perform the work
- Medical claim billing and/or coding experience is extremely valuable, but not required
- Experience in the pharmaceutical field is helpful, but not required.
- Professional oral and written communication skills, including excellent phone communication skills
- Comfortable working in computer applications
- Very strong critical thinking, attention to detail, and organizational skills
- Ability to work well independently or in a team environment
- Proficiency with Microsoft Word and Excel
Benefits
- PTO, Paid Holidays, and Volunteer Days
- Eligibility for health, vision and dental coverage, 401(k) plan participation with company match, and flexible spending accounts
- Tuition Reimbursement
- Eligibility for company-paid benefits including life insurance, short-term disability, and parental leave.
- Remote and hybrid work options
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