Medicaid Claims Analyst Position Available In Morris, New Jersey

Job Title:

Medicaid Claims Analyst Job Description We are seeking a Medicaid Claims Analyst to review summary data for claim submissions to ensure rebate eligibility. The candidate will perform detailed validation on claims, review for suspect claims, and determine disputed payments. The role includes resolving Medicaid disputes with states/programs and proposing, applying, and documenting proper payment amounts. The analyst will complete Medicaid analysis for assigned states/programs, provide backup for the Medicaid team on ad hoc projects, and compile Medicaid summary invoices, summary data files, and claim-level invoices quarterly. The role also involves reviewing for completeness and accuracy, uploading data into the Model N/Medicaid system, and authorizing transactions. Responsibilities Review summary data for claim submissions to ensure rebate eligibility. Perform detailed validation on claims and determine disputed payments. Resolve Medicaid disputes with states/programs. Propose, apply, and document proper payment amounts. Complete Medicaid analysis for assigned states/programs. Provide backup for Medicaid team on ad hoc projects. Compile Medicaid summary invoices, summary data files, and claim-level invoices quarterly. Review compiled documents for completeness and accuracy. Upload data into Model N/Medicaid system and authorize transactions. Essential Skills Proficient in Microsoft Excel, including pivot tables and VLOOKUPs. Strong analytical skills. Bachelor’s degree. Experience in pharmaceutical, PBM, medical device, or similar industry. Experience with rebates, chargebacks, or revenue cycle within the industry. Additional Skills & Qualifications Experience with systems such as Model N, Revitas, Flex Medicaid, etc. is a plus. Work Environment The position is part of a dedicated rebates team. The team is supportive and committed to providing training and development opportunities, helping candidates become more marketable. There is potential for long-term opportunities. The work environment includes collaboration with various team members, including a director, and manager