• Medicaid Rebate Claims Analyst

    Aston Carter (Parsippany, NJ)


    Job Title: Medicaid Claims Rebate Analyst

    Description

    The Medicaid Claims Analyst is responsible for Medicaid Drug Rebate process which includes validating, verifying, disputing when necessary, and remitting payment for assigned state Medicaid agencies, SPAPs and Supplemental Rebates. Analyst is accountable for submitting payments within deadlines and in compliance with CMS guidelines and rebate contract terms.

    Responsibilities:

    + Work with assigned states to get Medicaid Summary invoice, summary data file and Claim Level Invoice each quarter and review to ensure completeness of information received. Upload data into Medicaid systems and authorize transactions. Document errors and perform research.

    + Conduct initial quality check on summary data on all claim submissions to ensure rebate eligibility and data consistency.

    + Perform Claim Level Detail validation. Review suspect claim records and determines if record should be disputed for payment.

    + Resolve disputes and propose recommended amounts to be paid for historical outstanding utilization that is routinely submitted with Medicaid claims. Must have ability to work independently and make recommendation on state disputes, apply proper amounts to be paid & ensure CMS codes are applied correctly; notify states of results/findings.

    + Complete Medicaid analyzes and documentation on assigned states/programs. Communicate to manager for key findings and changes to state programs.

    + Provide backup for Medicaid team members in any necessary functions and work with team to establish best practices within Teva Medicaid work environment.

     

    Additional Skills & Qualifications

     

    + Bachelor’s degree/ High school Diploma or equivalent combination of experience, training and/or direct work related experience.

    + Experience Required:

    + Prior Medicaid Claim processing experience with a Pharmaceutical and/or med Device company , state and/or state agency or as Medicaid consultant or equivalent work experience

    + Experience Preferred:

    + Minimum 2+ years pharmaceutical/product focused healthcare experience; Medicaid Claim processing function; manipulation of large datasets, negotiation/conflict resolution. System Implementation and report writing.

    + Specialized or Technical Knowledge, License, Certifications needed:

    + Knowledge of the Model N or Revitas/Flex Medicaid and/or Flex Validata system (or other comparable system) and advance Microsoft Excel skills.

    + Familiar with CMS Medicaid rules and state specific issues. Up to date knowledge on Medicaid Validation rules and issues with 340B covered entities.

    + Strong ability to organize and manipulate large volume of data in various formats. Attention to detail and high degree of accuracy in data processing and reviews.

    + Company/Industry Related Knowledge:

    + Medicaid, Government Pricing and Rebate Pharmaceutical industry experience/knowledge prefer.

    Work Environment:

    This is a fully remote contract position based out of New Jersey.

     

    This position is moving extremely fast as this is an urgent need for the client. If interested, please send over your most up to date resume to ktrivigno @astoncarter.com along with your availability for a 10-minute phone call.

     

    Job Type & Location

     

    This is a Contract position based out of Parsippany, NJ.

    Pay and Benefits

    The pay range for this position is $50.00 - $70.00/hr.

     

    Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

     

    • Medical, dental & vision • Critical Illness, Accident, and Hospital • 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available • Life Insurance (Voluntary Life & AD&D for the employee and dependents) • Short and long-term disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance Program • Time Off/Leave (PTO, Vacation or Sick Leave)

     

    Workplace Type

     

    This is a fully remote position.

     

    Application Deadline

     

    This position is anticipated to close on Nov 20, 2025.

    About Aston Carter:

    Aston Carter provides world-class corporate talent solutions to thousands of clients across the globe. Specialized in accounting, finance, human resources, talent acquisition, procurement, supply chain and select administrative professions, we extend the capabilities of industry-leading companies. We draw on our deep recruiting expertise and expansive network to meet the evolving needs of our clients and talent community with agility and excellence. With offices across the U.S., Canada, Asia Pacific and Europe, Aston Carter serves many of the Fortune 500. We are proud to be a ClearlyRated Best of Staffing® double diamond winner for both client and talent service.

     

    The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

     

    If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email [email protected] (%[email protected]) for other accommodation options.