Pharmacy Claims AuditorVirtualVocations • Orlando, Florida, United States
Pharmacy Claims Auditor
VirtualVocations • Orlando, Florida, United States
[job_card.1_day_ago]
[job_preview.job_type]
- [job_card.full_time]
[job_card.job_description]
A company is looking for a Pharmacy Claims Auditor - Remote.
Key Responsibilities
Conduct in-depth analysis of large datasets and audit findings to identify high-risk pharmacy claims and billing irregularities
Research and select appropriate audit samples, prioritizing claims based on risk indicators
Evaluate pharmacy claims against contractual terms and educate pharmacies on compliance best practices
Required Qualifications
Bachelor's degree in Health Science or related area, or equivalent combination of education and experience; High school diploma or GED required
2 years of experience in pharmacy or Pharmacy Benefit Management, including 1 year in operations, audit, or quality assurance
National Pharmacy Technician Certification through PTCB or ExCPT (CPhT)
Must be eligible to work in the United States without sponsorship
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