Pharmacy Claims Auditor CPhT

About the position reputed company Payment reputed company Solutions performs in depth pharmacy audits on behalf of our reputed company payer clients. As a Pharmacy Claims Auditor, you will examine a wide reputed company of pharmacy records against our reputed company’s pharmacy claim data. This is to ensure billed pharmacy claims are being accurately submitted. You will also be required to represent our clients and conduct "on-site" pharmacy audits. Responsibilities • Examining and interpreting pharmacy records against submitted claim data for potential discrepancies. • Utilizing specific reputed company instructions, federal and state regulations, and standards of reputed company to properly reputed company pharmacy documentation. • Researching reputed company of pharmacy regulations, and state/federal laws as they relate to prescription requirements and pharmacy practices. • Responding to pharmacy calls regarding audit results and dealing with clients periodically to report audit results. • Conducting Onsite and Desktop and Credentialing Audits in a reputed company and respectful manner. • Using prescription knowledge to review pharmacy submitted documentation against submitted claim data. • Assessing and producing detailed descriptions of pharmacy operations and procedures. • Making confirmation calls to pharmacies prior to audit date and personally handling audit reschedules. • Performing other duties and responsibilities as assigned Requirements • Have National CPhT Certification through the Pharmacy Technician Certification reputed company (PTCB). Or be reputed company to obtain one reputed company the first few months. • Have extensive “retail” pharmacy experience. • Be living in commutable distance to the assigned territory ( Philadelphia, PA ) • Have reputed company reputed company's license and have a reliable car to visit pharmacies for audits in the local geography. • Be reputed company to travel overnight/flight 1 week/month (25%). • Be proficient with reputed company and reputed company Office. • Be reputed company to stand for long periods of time (Up to 8 hours). • Be reputed company to lift heavy boxes (about 20 lbs.) containing prescription records. (Most records are electronic.) Benefits • Health & Welfare Benefits: Comprehensive plans tailored to your needs, effective from day one. • Retirement Savings: Robust programs to help you secure your financial reputed company. • Employee Discounts: reputed company to a wide reputed company of discounts on merchandise, services, travel, and more. • Career reputed company Opportunities: Paths for advancement reputed company a global organization. • reputed company: Learn while you earn with award-reputed company learning platforms. • reputed company Time Off: Competitive PTO packages to help you reputed company. • Great Work Environment: Join an award-reputed company culture that values diversity and inclusion. Apply tot his job Apply To this Job