Position Overview
We're looking for a Pharmacy Claims Auditor to safeguard our claims data and prevent fraud. You'll conduct audits, analyze billing activities, and ensure compliance with regulations.
What Youll Do:
Conduct desk and on-site pharmacy audits.Review claims for errors, discrepancies, or fraud.Communicate with pharmacies to resolve billing issues.Prepare audit reports and recommend corrective actions.Document findings and ensure client invoicing accuracy.What You'll Bring:
Bachelor's degree + 1 year pharmacy experience (Long Term Care, Specialty, or Mail Order a plus).Pharmacy Technician license required; national certification preferred.Strong knowledge of pharmacy practice, laws, and regulations.Proficient in MS Office; SQL/SAS knowledge a plus.Excellent analytical, problem-solving, and communication skills.