Rebate Pharmacist

Overview

Job Description:

We are looking for a Rebate Pharmacist, specializing in NDC-HCPCS Crosswalk scope, to support Medicaid pharmacy rebate operations and claims adjudication. This role is responsible for creating, updating, and maintaining the NDC-HCPCS Crosswalk, which will be used to determine rebate eligibility and guide payment decisions for physician-administered drugs in Medicaid programs. The ideal candidate possesses a clear understanding of how crosswalk management affects CMS rebate invoicing and claims adjudication.

This person should have experience managing NDC-HCPCS crosswalks in a Medicaid environment or for a Medicaid claims processor.

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances.

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• Create, update, and maintain the HCPCS–NDC Crosswalk used to determine rebate eligibility and guide payment decisions for physician-administered drugs in Medicaid programs.
• Understand and communicate how crosswalk management impacts CMS rebate invoicing and claims adjudication.
• Manage NDC-HCPCS crosswalks in a Medicaid environment or for a Medicaid claims processor.

• Excellent written and verbal communication
• Medicaid rebate experience
• 3-5 years medical billing knowledge
• 1+ years rebate experience
• Experience managing, developing, or maintaining a HCPCS–NDC Crosswalk in a Medicaid or claims processing environment
• Hospital/outpatient pharmacy experience (highly preferred)
• BA/Data Analysis skills
• Clinical experience