Pharmacy Claims Auditor

Job description:

We are looking for a Pharmacy Claims Auditor to perform a variety of pharmacy audit duties. To succeed in this role, you should be an exceptional communicator with an analytical mind, attention to detail and sound judgement. Willing to travel 50% of the time.

Responsibilities

• Schedule and prepare for onsite audit trips
• Review pharmacy prescriptions for compliance to State and Federal regulations
• Enter potential discrepancies into the IPS audit software
• Complete store credentialing worksheet
• Collect signature log verifications
• Explain audit findings and recommend solutions
• Must be able to travel 50% of the time.

Skills

• Knowledge of the most common medications and usual dosages
• Understanding of methods of filling prescriptions and submitting claims
• Experience with third party (insurance) billing procedures
• Interpreting prescriptions accurately
• Ability to analyze large amount of pharmacy claims data
• Awareness of pharmacy prescription laws and regulations
• Attention to details, accuracy and quality
• Computer proficient in Microsoft Office products as well as pharmacy computer systems
• Excellent verbal and written communication skills
• Sound judgement and decision-making ability
• Strong organizational skills
• Keen attention to detail

Ideal candidates must be able to work independently, be self-motivated, have good organizational skills and excellent customer service skills. Ability to identify issues, investigate matters and creatively work to resolve unexpected and unanticipated problems. Travel is required.

Qualified candidates must be a registered Pharmacy Technician and ideally have 3 plus years' experience as a Nationally Certified Pharmacy Technician.

Work Remotely

• Yes

Job Type: Full-time

Benefits:

• 401(k)
• Dental insurance
• Flexible spending