Job Description

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.