Position Overview
Description We are looking for an Auditing Clerk to support pharmacy claim review activities for a Long-term Contract position based in New York, New York. This role focuses on examining recently paid prescription claims, validating supporting documentation, and identifying irregularities related to billing, dispensing, and prescribing activity. The ideal candidate brings strong audit experience, careful attention to detail, and the ability to interpret documentation requirements in a highly regulated environment.
Responsibilities:
• Review a selected group of recently processed pharmacy claims through remote desk audits to confirm accuracy and compliance.
• Examine prescription records and related materials such as signature logs, delivery confirmation, copayment verification, pharmacist review details, compound documentation, and other dispensing support files.
• Assess prescribing behavior, referral activity, override usage, ingredient cost accuracy, geographic tre...