• Insurance Reimbursement Specialist

    Job Locations US-WI-Milwaukee
    Job ID
    # of Openings
    Hidden (45521)
  • Overview


    Patient Minded I act with the patient’s best interest in mind.

    Client Delight I own every client experience and its impact on results.

    Take Action I am empowered and empower others to act now.

    Grow Talent I own my development and invest in the development of others. 

    Win Together I passionately connect with anyone, anywhere, anytime to achieve results.

    Communication Matters I speak up to create transparent, thoughtful and timely dialogue.

    Own It I hold myself and others accountable for results.



    The Insurance Reimbursement Specialist is primarily responsible for chargeback rebate invoice processing for various EVERSANA clients. 



    • Complete processing of Chargeback and Medicaid services in accordance with the department SOPs
    • Perform services related to transactional processing with zero defects.
    • Establish and maintain positive relationships with co-workers, clients, state program contacts, etc.


    Essential Duties and Responsibilites:

    • Must be able to maintain SOP established service levels of Chargeback and Medicaid rebate processing across several client drug manufacturers.
    • Validate and reconcile Chargeback transactions and Medicaid invoices, including resolution of variances or discrepancies.
    • Perform contract administration activities
    • Perform necessary administrative duties related to Chargeback and Medicaid processing
    • Maintain an organized audit trail.
    • Collaborate with key state Medicaid administrators toward claim dispute resolution.
    • Develop and maintain lasting relationships to accurately and quickly achieve results.
    • Respond to client inquiries and/or request for ad hoc reports/analysis.
    • Support relationships and engage in effective communications with clients.
    • Other internal and external duties/projects as assigned.


    The above list reflects the general details necessary to describe the principle and essential functions of the position and shall not be construed as the only duties that may be assigned for the position.


    An individual in this position must be able to successfully perform the essential duties and responsibilities listed above. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position.



    MINIMUM Qualifications:

    The requirements listed below are representative of the experience, education, knowledge, skill and/or abilities required.


    • High school diploma and a minimum of five years of work related experience in a professional environment.  Or AA / AAS/ AS degree in a business related area
    • The ability to perform detail-oriented work accurately, handle several assignments simultaneously, maintain confidential information, and complete assigned tasks in a timely manner.
    • Must be receptive to training and diligent in learning and working under the processes and procedures in place.
    • Proficiency using the following software: Microsoft Excel, Microsoft Word, Microsoft Outlook.  The ability to learn and become proficient in company software packages.


    Preferred Qualifications:


    • Associate degree in a business related area.
    • Prior experience with Chargeback and Medicaid processing



    • Interact positively in a team orientated environment. 
    • Strong mathematical, analytical and customer service skills.
    • Strong written, verbal and interpersonal communication skills are critical to this position.

    The mental and physical requirements described here are representative of those that must be met by an individual to successfully perform the essential functions of this position.


    Working ENVIRONMENT:

    To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 

    The work environment characteristics described here are representative of those an individual encounters while performing the essential functions of this position.




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