Pharmacy Auditor (SIU/Audit)
¿Es esta oferta para usted?
Crear mi CV Cree su CV y descubra su porcentaje de coincidencia con este puesto — y con todos los demás.
Sigue tus candidaturas desde el móvil La app gratuita de Whileresume, en iPhone y Android.
El puesto
Conduct pharmacy desk and field audits to verify the accuracy of billed claims and supporting documentation.
Review prescriptions, invoices, and dispensing logs to identify discrepancies and ensure NDC accuracy and proper days' supply.
Document issues related to quantity, reimbursement mismatches, purchase vs. dispensing, and duplicate or non-covered items.
Draft clear, defendable audit findings reports and calculate recoveries or overpayments where applicable.
Collaborate with SIU, Compliance, Legal, Finance, and Provider Relations to support fraud, waste, and abuse (FWA) detection and program integrity.
This is a 100% remote contract role requiring 3–5 years in pharmacy auditing or related fields, strong Excel (pivot, VLOOKUP), PBM system experience, and familiarity with NCPDP standards and third-party billing rules.
Review prescriptions, invoices, and dispensing logs to identify discrepancies and ensure NDC accuracy and proper days' supply.
Document issues related to quantity, reimbursement mismatches, purchase vs. dispensing, and duplicate or non-covered items.
Draft clear, defendable audit findings reports and calculate recoveries or overpayments where applicable.
Collaborate with SIU, Compliance, Legal, Finance, and Provider Relations to support fraud, waste, and abuse (FWA) detection and program integrity.
This is a 100% remote contract role requiring 3–5 years in pharmacy auditing or related fields, strong Excel (pivot, VLOOKUP), PBM system experience, and familiarity with NCPDP standards and third-party billing rules.
Ver la oferta completa
Funciones, perfil, competencias y ventajas — crea tu cuenta gratis.
o
¿Ya tiene una cuenta?
Iniciar sesiónEstas ofertas podrían interesarte
Ninguna oferta realmente parecida por ahora — estas son las más recientes.