GPS Audit Analyst
If you’re interested in a career within a customer-focused, team-oriented environment that rewards innovation, quality, integrity and collaboration, MedImpact Healthcare Systems, Inc. welcomes your application. MedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego, California. Our solutions and services positively influence healthcare outcomes and expenditures, improving the position of our clients in the market. MedImpact offers high-value solutions to payers, providers and consumers of healthcare in the U.S. and foreign markets.
The Government Programs & Services Audit Analyst works both internally and externally to ensure thorough research of all audit questions related to Part D claims processing, PDE calculations, and all Part D, Medicaid and Marketplace programs handled by the Government Programs and Services department and creates appropriate reports to communicate the results.
Essential Functions and Responsibilities include the following. Other duties may be assigned.
Education and/or Experience
For consideration, candidates will need a Bachelor degree in a related field (or equivalent combination of education and job related experience); minimum of two (2) plus years’ experience with Medicare Part D; must have in-depth knowledge of pharmacy/PBM claims processing and an understanding of PDE record calculations and Part D rules. Prior background should include at least two (2) to two (2) plus years’ medical claims adjudication and/ or audit experience. Prior experience is required in the healthcare field, PBM or closely related industry.
Solid computer skills with Microsoft Office Suite (Word, Excel, and Outlook) as well as CRM tool such as Salesforce along with advanced knowledge working with databases. Skilled use of MedAccess is a plus.
Other Skills and Abilities
This position may require occasional travel and attendance at local seminars and conferences.
This position is eligible for Employee Referral Bonus
To perform this job successfully, the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.