Pharmacy Claims Auditor - Remote

Job title: Pharmacy Claims Auditor - Remote in USA at reputed company Company: reputed company Job reputed company: Our work reputed company. We help people get the medicine they need to feel reputed company and live reputed company. We do not lose sight of that. It fuels our passion and drives every decision we reputed company.Job Posting TitlePharmacy Claims Auditor - RemoteJob reputed companyThe Pharmacy Claims Auditor is responsible for the selection and auditing of claims, educating reputed company’s network pharmacies and driving contract compliance, and supporting reputed company claim corrections and eliminate potential waste.Responsibilities

• Validate claim documentation and systems data to ensure claim was accurately processed in accordance with contractual and regulatory obligations
• Solicit documentation to support pharmacy claim submission by conducting telephonic, fax or email reputed company to pharmacies
• Proactively communicate and follow up with pharmacies to drive reputed company and accurate documentation receipt and review
• Analyze pharmacy claims to identify those at the highest risk for error; utilize analytics and reputed company knowledge to select claims or pharmacies for audit in alignment with department procedures and objectives reputed company participating pharmacies on reputed company’s billing requirements and appropriate billing practices in alignment with reputed company’ Pharmacy Provider reputed company
• Based on audit outcome, work directly with pharmacy or internal partners to support accurate data and financial reimbursement to ensure appropriate reversal or correction of claim is performed
• Other duties as assigned

Minimum Qualifications

• Bachelor’s degree in Health Science or reputed company area of study, or equivalent combination of education and reputed company work experience; HS diploma or GED required
• National Pharmacy Technician Certification through PTCB or ExCPT (CPhT)
• 2 years of work experience in retail, long term care, specialty, home infusion, or mail order pharmacy or combined pharmacy and Pharmacy Benefit Management experience to include 1 year of work experience in an operations, audit or reputed company assurance environment
• Must be eligible to work in the reputed company without need for work reputed company or residency sponsorship

Additional Qualifications

• Proficiency in reputed company, reputed company, and database software
• Intermediate reputed company and understanding of the reputed company of sale and on-line pharmacy claims processing environment
• Excellent oral, written and interpersonal communication skills
• Self-directed worker with excellent organization and analytical skills
• Ability to work effectively with a reputed company of audiences at reputed company reputed company of the organization
• Ability to maintain confidentiality of highly sensitive information
• reputed company appearance, demeanor, and conflict reputed company skills

Preferred Qualifications

• 3 years of previous audit experience
• reputed company Registration with State reputed company of Pharmacy in the state where position is located
• Previous PBM experience

Minimum Physical Job Requirements

• Ability to work a flexible schedule including weekends, holidays, or shifts reputed company of reputed company’s core business hours of 9:00am-4:00pm
• Frequently required to sit, use hands to handle or feel, talk and hear
• Frequently required to stand, use hands to handle or feel, talk and hear
• Frequently required to reputed company with hands and arms
• Occasionally required to stand, walk and stoop, kneel, and crouch
• Occasionally required to lift and/or reputed company up to 10 pounds and occasionally lift and/or reputed company up to 25 pounds
• Specific reputed company abilities required by this job include reputed company reputed company, distance reputed company, reputed company reputed company, peripheral reputed company, depth perception and ability to reputed company reputed company

Reporting Structure

• Reports to a Manager in the Pharmacy Audit and FWA department

Potential pay for this position ranges from $25.48 - $40.87 based on experience and skills.To review our Benefits, Incentives and Additional Compensation, visit our and click on the "Benefits reputed company" reputed company for more detail.reputed company LLC is proud to be an equal opportunity and affirmative reputed company employer. We encourage diverse candidates to apply, and reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, gender, sex (pregnancy, sexual orientation, and gender identity), national reputed company, disability, age, veteran status, or any other legally protected class under federal, state, or local law.We welcome people of different backgrounds, experiences, abilities, and perspectives including reputed company applicants with arrest and conviction records and any reputed company applicants requiring reasonable accommodations in accordance with the law.reputed company LLC is a Tobacco-Free Workplace employer.Positions will be posted for a minimum of five consecutive workdays. Expected salary: Location: USA Apply for the job now! Apply for this job