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MedImpact Healthcare Systems, Inc. logo
MedImpact Healthcare Systems, Inc.

Independent, Transparent, Flexible.

Prescription Drug Event Analyst I

EventsEventsFull TimeRemoteJuniorTeam 1,001-5,000Since 1988H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

11 days ago

Salary

$22 - $35 / hour

Seniority

Junior

Bachelor Degree1 yr expEnglish

Job Description

Prescription Drug Event Analyst I

MedImpact Healthcare Systems, Inc.

• Analyzes and reconciles PDE entries rejected by CMS, including adjustments related to eligibility, TrOOP, cost sharing, gap discounts and LICS status. • Identifies gaps in the benefit and formulary design structure and ensures prompt resolution of all setup issues that impact claims adjudication. • Defines and documents requirements for technical specifications, data requirements, and procedures to support all components of Medicare claims data analysis, reconciliation, and validation. • Utilizes multiple company databases to obtain, record, and analyze complex claim information. • Performs calculations, completes quality control and testing, and ensures appropriate updates and adjustments of the data prior to submission to customers. • Maintains current understanding of customers' Medicare Part D coverage and benefit plans in order to accurately analyze and prepare Medicare claims data for transmission to customers. • Recommends improvement in workflow processes by suggesting procedural enhancements supporting timely and accurate PDE submissions. • Ensures continuous improvement of Medicare claims data through root cause analysis of errors, recommendations for systems and procedure enhancements, and education and training as appropriate. • Responsible for the establishment and maintenance positive working relationship with both internal and external customers. • Participates in customer conference calls as the subject matter expert presenting and clarifying Medicare Part D claims data.

Job Requirements

  • BS/BA and 1+ years’ experience or equivalent combination of education and experience
  • Detailed understanding of claim processing concepts
  • Ability to prioritize urgent issues effectively
  • Outstanding numeric, verbal, written, logic and analytical skills
  • Understanding of basic financial concepts
  • Detail oriented with a high degree of accuracy & follow through
  • Self-starter with the ability to work independently & as part of a team
  • Ability to influence others, lead small work groups, and coordinate service requests throughout the organization
  • Strong passion for the customer
  • Knowledge of healthcare operating systems preferred.

Benefits

  • Medical / Dental / Vision / Wellness Programs
  • Paid Time Off / Company Paid Holidays
  • Incentive Compensation
  • 401K with Company match
  • Life and Disability Insurance
  • Tuition Reimbursement
  • Employee Referral Bonus

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