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Medicaid Dispute Resolution ~ Managed Care & Medicare Rebate Management

Chargebacks Rebate Management ~ Contract Management ~ Government Pricing

         Offer 10+ years industry experience and a proven track record in steering an efficient chargeback resolution process to mitigate and control disputes.

         Proactively plan, coordinate, and directly support initiatives to increase eliminate errors and streamline analytics and reporting processes.

         Collaborate with all internal departments to achieve and sustain optimal levels of efficiency, timeliness, and accuracy within contract operations.

         Adept at researching and thoroughly investigating chargeback errors to proactively mitigate issues with accounts.

         Able to anticipate and identify issues with accounts that could lead to revenue loss, and provide potential, practical, and immediate solutions to resolve problems.

Johnson & Johnson Health Systems, Piscataway, NJ, 2013 Present

MD&D Chargeback Analyst

         Analyze, process, and manage distributor chargeback credits via ICS and SAP systems.

         Spearhead dispute resolution for major Med-Surg distributors such as Owens & Minor, Cardinal, and PHS.

         Train, coach, mentor, and supervise chargeback analysts in properly navigating dispute process.

         Conduct root cause analysis as needed to successfully resolve rebate discrepancies.

         Meticulously administer accounts receivable for rebate credits and deductions via internal systems.

         Prepare monthly audit packages and month-end closings for distributors.

West-Ward Pharmaceuticals, Eatontown, NJ, 2011 2012

Chargeback Analyst (contractor)

         Supported divestiture project by accurately and efficiently entering chargebacks from wholesale and distributor customers into SAP.

         Verified, processed, and reconciled chargebacks specific to pricing, membership eligibility, effective dates, GPOs, PHS/340B entities, and COT for all wholesale/distributor customers.

         Ensure and optimized quality control by isolating cause of disputed lines and implementing prompt corrective action to eliminate future occurrences.

         Critically evaluated chargeback discrepancies due to customer deductions, accurately reconciled differences, and initiated collection activities where necessary.

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Professional Experience continued

Meda Pharmaceuticals Inc, Somerset, NJ, 2009 2010

Government Pricing Analyst

         Oversaw monthly or quarterly submission of government-related calculations for AMP, Best Price, Rebate Per Unit, Prompt Pay Discounts, PHS pricing, FAMP/Non-FAMP, FSS/FCP, IFF, SPAP and Supplemental Rebates, VA/DoD Pricing, and contract modifications/renewals.

         Methodically calculated and submitted pricing for Supplemental Contracts for participating states.

         Directed, mentored, and supervised Rebate Analyst in Medicaid payment tracking procedures, billing functions, government pricing process, and dispute resolution policies and practices.

         Conducted systematic analysis of Medicaid, Supplemental, and SPAP disputes to expedite resolution.

         Served as primary point of contact for representatives from VA/DOD and tasked with in-depth review, approval, and modifications to contracting proposals.

         Fostered, nurtured, and maintained cooperative customer relationships through timely communication and respectful negotiations with Federal, State, and local government officials.

Forest Laboratories Inc., New York, NY, 2007 2008

Government Contract Analyst CARS Medicaid

         Championed full-scope dispute process for Forest s Medicaid claim process via 3^rd party prescription/claim-level detail from Data Niche Associates.

         Effectively interpreted state & federal contracts and leveraged sharp organizational skills toward validating rebate claim data to ensure accurate payments.

         Joined forces with business partners to resolve dispute resolutions within contract agreements.

         Established and implemented departmental SOPs to streamline DNA Medicaid dispute resolution.

         Proficiently conducted comprehensive analysis of Medicaid, Supplemental, and SPAP disputes.

         Cultivated strong customer relations with government officials to optimize business continuity.

         Trained, advised, coached, and supervised Government Pricing Analyst on dispute resolution process.

Novartis Pharmaceuticals, East Hanover, NJ, 2004 2006

Sr. Government Rebate Analyst - CARS Medicaid

         Retained full-time following successful contract assignment as Managed Care Rebate Analyst and tasked with accurately processing rebate claims for 25 states and reimbursement programs.

         Helmed evaluation and interpretation of Managed Care, Medicare, and Medicare Part D contracts.

MS, Management, major in MIS, New Jersey Institute of Technology, Newark, NJ

BS, Accounting, Rutgers University, Newark, NJ

Microsoft Office (Word, Excel [pivot tables, v-lookups], PowerPoint, Access, Outlook),

DDR, SAP, Model N, IMANY/CARS/COGNOS, iContracts, JDE, Tableau