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Documentation Specialist I
Ref No.: 18-06278
Location: North Wales, Pennsylvania
***Must be willing to work overtime for quarter end 2-3 weeks which includes weekends.

***MUST have extensive Excel/Pivot table experience; resumes must show this skill set along with below requirements.

Position Summary: This rolet will ensure all invoices are input to respective Revitas & Validata systems. Request all claim level detail and ensure all information is stored in respective files. Incumbent will handle all invoices for Federal Fee for Service, Managed Medicaid, State Pharmaceutical Assistance programs, Aids Drug Assistance programs, Physician Administered J-Code and ACA Expansion Programs. Work directly with the Sr. Manager to help resolve system issues with Revitas and ensure all invoices are received timely. Able to multi-task responsibilities, prioritize accordingly to meet quarterly deadlines, and accomplish tasks with minimal supervision.
Travel Requirements: Minimal.

Essential Duties & Responsibilities Percentage of Time

1. Handle all quarterly invoices and enter into Revitas system for all programs: Federal Fee for Service, Managed Medicaid, State Pharmaceutical Assistance programs, Aids Drug Assistance programs, Physician Administered J-Code programs and ACA Expansion Programs. 35%
2. Validate invoices to ensure Units/Rx and rebate amounts are correct on invoice. Identify invoice discrepancies which require correction due to inaccurate reporting by state. Makes quality work-related decision based on sound conclusions of data. Able to complete assignments and works with minimal supervision. Communicate to state based on recommended and/or proposed changes based on results findings. 20%

3. Request claim level detail for brand and generics; format and map into Validata system. Work closely with IT resolve format issues with import files. Meet deadlines and follow instructions. Thinks and acts independently and promptly address problems. 15%

4. Notify Sr. Manager of Medicaid of any invoice notification and/or potential system issues related to invoices by third party providers. 5%
5. Prep all packets for filing and ensure all invoices, notifications, claim level detail, text files and response from state are stored in shared directory. 5%
6. Prep and email all states ROSI/PQAs via secure email; ensure all payments are sent to all states timely. Ensure all ACH are setup with AP. 5%
7. Review of Client Medicaid usage to determine which state formularies could be excluding a Client NDC from its program and work to add such products to state formularies. Note: Such actions will add to Client's sales totals via spillover measures. 10%
8. Can be relied upon to meet work schedules and fulfill job responsibilities and commitments & other duties as assigned. 5%

Position Requirements:
Education Required: High School Diploma or GED required
Education Preferred Bachelor's Degree preferred
Experience Required: 3+ years of experience handling Medicaid claims or similar finance detail within a pharmaceutical company. Equivalent combination of education and experience will be considered.

Experience Preferred: Pharmaceutical industry or Accounting/Finance related experience.
Specialized or Technical Knowledge, License, Certifications needed: Proficient in Microsoft Excel required; Oracle, SAP, Business Intelligence, Oracle Discoverer.
Functional Knowledge and skills: Knowledge of the Revitas Medicaid and/or Validata system (or other comparable system).