Coordinator, Industry Analysis
Based in United States
Core
Supporting Maximum Allowable Cost (MAC) list maintenance, analysis, and pricing adjustments for pharmacy claims to ensure client commitments and regulatory compliance.
Role type
Coordinator, Industry Analysis (Pharmacy Claims)
Builds
MAC pricing lists and reports for pharmacy adjudication platforms
Domain
Health Insurance / Pharmacy Claims
Deliverable
dashboards & analysis
Required skills
Pharmacy claims experience, MS Office, Data validation, Regulatory compliance, Database management
Preferred skills
RxClaim, Access Database, SAS
Responsibilities
Reviewing and resolving MAC pricing inquiries from pharmacies, Validating information from sources like Medi-Span and manufacturers, Updating the Pharmacy Inquiry Database, Monitoring pharmacy GER guarantees, Preparing and distributing client and pharmacy reports
