Lead, Pharmacy Rebate Specialist, Medi-Cal
Company: Magellan Health
Location: Rancho Cordova
Posted on: June 13, 2022
Job Description:
This position is responsible for providing backup support to the
supervisor with the ability to independently resolve escalated
issues. Maintains consistent high-quality performance. Trains and
leads team members. Provides assistance to supervisor in all
aspects other than personnel related activities.
- Support the Rebate Supervisor(s) to oversee day-to-day rebate
operations, providing work assignments to ensure contractual SLAs
are being met.
- Serves as secondary point of contact for all escalations when
Supervisor is unavailable.
- Understands and adheres to departmental policies and
procedures.
- Leads new hire and refresher training to team members.
- Provides procedural and/or system demonstrations, as
needed.
- Maintains a clear understanding of rebate client contractual
requirements ensuring compliance with service level
agreements.
- Performs quarterly manufacturer rebate invoicing for assigned
clients or manufacturers.
- Creates and maintains invoicing practices, including
pre-invoicing quality reviews and adjustments for fee for service,
managed care, diabetic supply and supplemental rebate
programs.
- Produces reports, including federal rebate 64.9R. -
- Works directly with manufacturers pertaining to dispute
resolution.
- Serves as primary contact for manufacturers to answer/resolve
rebate questions.
- Conducts quality validation and approval of claim files.
- Provides subject matter expertise for internal and external
audits providing requested information and support.
- Assists with payment posting and Dunning letter (late notice)
management.
- Assists Account Management with client requests.
- Identifies areas of improvement and shares with
leadership.
- Mentors Billing Specialists and acts as resource for
Q&A.
- Assists with application updates and testing.
- Attends meetings and conference calls with clients and drug
manufacturers.
- Provides training and participates in interviews/hiring process
as needed.Other Job Requirements Responsibilities7+ years of
experience in customer support, analysis or business preferably
within a financial environment.Bachelor's degree required or an
additional 4 years of relevant experience in lieu of
degree.Possesses progressive experience as a rebate
specialist.Demonstrates master/expert skills in research and
analysis.Proven leadership skills.Strong verbal and written
communication skills.Strong working knowledge of Microsoft Word and
Excel.General Job Information TitleLead, Pharmacy Rebate
Specialist, Medi-Cal Grade21 Work Experience - RequiredCustomer
Service, Data Analysis, Operations Work Experience - Preferred
Education - RequiredA Combination of Education and Work Experience
May Be Considered., Bachelors Education - PreferredLicense and
Certifications - RequiredLicense and Certifications - PreferredCPT
- Certified Pharmacy Technician - Pharmacy Magellan Health, Inc. is
proud to be an Equal Opportunity Employer and a Tobacco-free
workplace. EOE/M/F/Vet/Disabled.Every employee must understand,
comply with and attest to the security responsibilities and
security controls unique to their position; and comply with all
applicable legal, regulatory, and contractual requirements and
internal policies and procedures.
Keywords: Magellan Health, Rancho Cordova , Lead, Pharmacy Rebate Specialist, Medi-Cal, Healthcare , Rancho Cordova, California
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