Pharmacy Claims Auditor

Job Summary

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

Key Responsibilities

• Validate claim documentation and systems data to ensure accurate processing in line with obligations
• Solicit and review 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 education and experience; HS diploma or GED required
• National Pharmacy Technician Certification through PTCB or ExCPT (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 or residency sponsorship