Drug Claim (Pharmacy) Analyst
Company: The Rawlings Group
Location: La Grange
Posted on: March 19, 2023
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Job Description:
The Drug Claim Payment Integrity Retro Term Recovery Analyst is
responsible for maximizing the recovery of pharmacy claim
overpayments. The Analyst evaluates outstanding balances on
pursuable inventory to determine the appropriate approach to
generate recoveries for our clients. The Analyst will make outreach
to dispensing pharmacies, members, and insurance carriers to
explain the reason why the claims were paid in error, assist with
refiling charges with the appropriate party, and sending appeal
letters for any denied claims to insurance carriers in a timely
manner. The Analyst will also handle all member communications for
collection or endorsement of funds with professionalism and in
accordance with Company standards and federal regulations such as
FDCPA.
Hours: Day shift, 40-hour work weeks. During training, 8am -
5pm.
Setting: Professional office environment (with remote opportunity
available after six months of employment based on performance).
Compensation: This is an exempt position at a very competitive
salary, $47,000 with significant bonus opportunity. Top 20% of our
Analysts earned $85,000+ last year. Our comprehensive benefit
package includes health and dental benefits, short-term disability
plans, 401k with company matching, paid time off policy and more.
We also offer an onsite gym, cafe, and coffee shop.
Training: The Rawlings Company takes great pride in providing
exemplary training and development program, including policies and
procedures, state-of-the-art proprietary systems, and many other
tools to place new employees on the path to success.
Responsibilities
Qualifications
Physical Requirements
Our Company Culture
The Rawlings Group is looking for hard-working, talented people who
share our commitment to excellence to join our company. The
Rawlings Company has successfully provided cost containment
services to the largest health insurers in the country for more
than 40 years and continues to grow as an industry leader.
Our Culture is focused on:
Our Values are:
Equal Employment Opportunity. It is our policy to recruit, hire,
train, and promote people without regard to race, color, religion,
sex, national origin, age, sexual orientation, gender identity or
expression, disability, or veteran status, except where age, sex,
or physical status is a bona fide occupational qualification.
#INDHP
Keywords: The Rawlings Group, Louisville , Drug Claim (Pharmacy) Analyst, Healthcare , La Grange, Kentucky
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