Job Description
CLAIMS AUDITOR

We are seeking a Claims Auditor with QI experience to become part of our team!

Under general supervision of the QI Manager, and in accordance with local, state, federal and company laws and regulations ensure delivery of excellent customer service through fast, professional and accurate communication.

Hours: 9:00am-5:00pm, Monday-Friday

RESPONSIBILITIES
+ · Prepare and support timely and accurate responses to pharmacy payer audits, desk audits, and onsite audits.

· Review claim data and dispensing records to identify billing errors, discrepancies, and compliance issues.

· Obtain, validate, and organize requested documentation in support of audit responses.

· Apply federal, state, and local pharmacy laws, payer policies, and internal procedures during audit reviews.

· Document audit findings, corrective actions, and outcomes ...