Pharmacy Claims Auditor - State Licensed

Job Summary

A company is looking for a Pharmacy Claims Auditor - Remote.

Key Responsibilities

• Validate claim documentation and systems data for accuracy in processing
• Solicit and follow up on documentation from pharmacies to support claim submissions
• Analyze pharmacy claims to identify errors and educate pharmacies on billing practices

Required Qualifications

• Bachelor's degree in Health Science or related field, or equivalent experience; HS diploma or GED required
• National Pharmacy Technician Certification (CPhT)
• 2 years of experience in pharmacy or Pharmacy Benefit Management, including 1 year in operations, audit, or quality assurance
• Must be eligible to work in the U.S. without visa sponsorship
• Proficiency in MS Word, Excel, and database software