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Entry Level Pharmacy Claims Auditor Jobs (NOW HIRING)

RiteChoice Rx

Claims Auditor

Pharmacy auditing, medical billing auditing, or pharmacy technician experience is strongly preferred. Supervision The Claims Auditor will report directly to the Compliance Manager. * This is a ...

Moda Health

Lead Medical Claims Auditor I

Milwaukie, OR

$20.88 - $23.49/hr

Medical, Dental, Vision, Pharmacy, Life, & Disability * 401K- Matching * FSA * Employee Assistance ... Minimum of 2 years of experience as a Claims Auditor. * Excellent reading, verbal and written ...

Meijer, Inc.

Entry-Level Pharmacy Technician

Midland, MI

$15 - $18.25/hr

Creating prescription labels and adjudicating insurance claims. * Completing paperwork related to filling prescriptions and receiving drug orders. * Ordering prescription medication for the Pharmacy ...

Meijer, Inc.

Entry-Level Pharmacy Technician

Midland, MI · On-site

$15 - $18.25/hr

Creating prescription labels and adjudicating insurance claims. * Completing paperwork related to filling prescriptions and receiving drug orders. * Ordering prescription medication for the Pharmacy ...

Meijer, Inc.

Entry Level Pharmacy Technician

Detroit, MI

$17.25 - $21/hr

Creating prescription labels and adjudicating insurance claims. * Completing paperwork related to filling prescriptions and receiving drug orders. * Ordering prescription medication for the Pharmacy ...

Meijer, Inc.

Entry Level Pharmacy Technician

Holland, MI · On-site

$16.75 - $20.25/hr

Creating prescription labels and adjudicating insurance claims. * Completing paperwork related to filling prescriptions and receiving drug orders. * Ordering prescription medication for the Pharmacy ...

Meijer

Entry Level Pharmacy Technician

Detroit, MI · On-site

$16 - $19.50/hr

Creating prescription labels and adjudicating insurance claims. * Completing paperwork related to filling prescriptions and receiving drug orders. * Ordering prescription medication for the Pharmacy ...

Meijer, Inc.

Entry Level Pharmacy Technician

Holland, MI · On-site

$16.75 - $20.25/hr

Creating prescription labels and adjudicating insurance claims. * Completing paperwork related to filling prescriptions and receiving drug orders. * Ordering prescription medication for the Pharmacy ...

Local Health Specialty

Pharmacy Technician

Saint Louis, MO · On-site

$16 - $19/hr

... entry-level Pharmacy Technician to work at our Juniper Pharmacy in St. Louis, MO. We are looking ... Resolve issues when they arise (e.g. rejected insurance claims) * Select the appropriate medicine ...

Meijer

Entry-Level Pharmacy Technician

Midland, MI · On-site

$13.75 - $16.75/hr

Creating prescription labels and adjudicating insurance claims. * Completing paperwork related to filling prescriptions and receiving drug orders. * Ordering prescription medication for the Pharmacy ...

Meijer

Entry Level Pharmacy Technician

Holland, MI · On-site

$16.25 - $19.75/hr

Creating prescription labels and adjudicating insurance claims. * Completing paperwork related to filling prescriptions and receiving drug orders. * Ordering prescription medication for the Pharmacy ...

AlohaCare

Pharmacy Technician

Honolulu, HI · On-site

$17.25 - $21/hr

... through auditing operational reports and utilizing the PBM's processing platforms. * Issue ... Daily Medicare rejected claim review to proactively resolve member rejected claims. Proactive ...

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Entry Level Pharmacy Claims Auditor information

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How much do entry level pharmacy claims auditor jobs pay per hour?

As of Aug 25, 2026, the average hourly pay for entry level pharmacy claims auditor in the United States is $26.83, according to ZipRecruiter salary data. Most workers in this role earn between $19.71 and $29.81 per hour, depending on experience, location, and employer.

What does an entry level pharmacy claims auditor do?

An Entry Level Pharmacy Claims Auditor is responsible for reviewing pharmacy claims to ensure they are accurate and comply with insurance policies and regulations. They check for billing errors, potential fraud, and verify that prescriptions are processed correctly. Their work helps prevent overpayments and ensures pharmacies are reimbursed appropriately. Typically, they analyze reports, communicate with pharmacies or insurance companies about discrepancies, and maintain detailed records of their findings.

What are the key skills and qualifications needed to thrive as an entry level pharmacy claims auditor, and why are they important?

To thrive as an Entry Level Pharmacy Claims Auditor, you need strong analytical skills, attention to detail, and a basic understanding of pharmacy claims processes, often supported by a degree in healthcare, business, or a related field. Familiarity with claims management software, Microsoft Excel, and sometimes pharmacy technician certification is typically required. Excellent organizational skills, problem-solving abilities, and effective communication help you stand out in this role. These skills and qualifications are crucial for ensuring accuracy, detecting discrepancies, and maintaining compliance in pharmacy claims auditing.

What are some common challenges faced by entry level pharmacy claims auditors and how can they be overcome?

Entry level pharmacy claims auditors often encounter challenges such as interpreting complex insurance policies, understanding various pharmacy billing codes, and identifying discrepancies in large datasets. To overcome these, it's important to become familiar with industry-standard coding systems (like NDC and ICD-10) and stay updated on payer requirements. Team collaboration and ongoing training are also essential, as more experienced auditors and supervisors can provide guidance and help troubleshoot unclear cases. Attention to detail and strong organizational skills will help streamline the audit process and improve accuracy.

What is the difference between Entry Level Pharmacy Claims Auditor vs Pharmacy Claims Processor?

AspectEntry Level Pharmacy Claims AuditorPharmacy Claims Processor
CredentialsHigh school diploma; some roles may prefer certifications in pharmacy or claims processingHigh school diploma; on-the-job training often provided
Work EnvironmentOffice setting, analyzing claims, auditing dataOffice setting, entering and processing claims
Employer & Industry UsageInsurance companies, pharmacy benefit managers, healthcare providersInsurance companies, pharmacy benefit managers, healthcare providers

Entry Level Pharmacy Claims Auditors focus on reviewing and verifying claims for accuracy and compliance, while Pharmacy Claims Processors handle the initial entry and processing of claims. Both roles are essential in the claims management process and share similar work environments and employer types.

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States with the most job openings for Entry Level Pharmacy Claims Auditor jobs include:

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Entry Level Pharmacy Claims Auditor jobs near you
Infographic showing various Entry Level Pharmacy Claims Auditor job openings in the United States as of August 2026, with employment types broken down into 72% Full Time, 14% Part Time, and 14% Contract. Highlights an 85% In-person, 10% Hybrid, and 5% Remote job distribution, with an average salary of $55,805 per year, or $26.8 per hour.

Claims Auditor

RiteChoice Rx

Remote

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted just now

Job description

Are you detail-oriented, analytical, and interested in helping pharmacies strengthen compliance and reduce audit risk? Do you enjoy reviewing information, identifying patterns, and helping teams improve their processes? RiteChoice Rx may be the right fit for you.
At RiteChoice Rx, you’ll be part of a growing independent pharmacy organization that partners with community health centers and providers to support patients across Philadelphia and surrounding areas. Our mission is simple: provide fast, friendly, and affordable pharmacy services to the communities we care about.
We are seeking an organized and compliance-focused Claims Auditor to join our Compliance Department. This role will support internal pharmacy claims auditing, help identify billing and documentation discrepancies, and work closely with pharmacy teams and operational leadership to strengthen audit readiness.
The ideal candidate is someone who can review claim details carefully, communicate findings clearly, and support a culture of compliance across the organization. Pharmacy auditing, medical billing auditing, or pharmacy technician experience is strongly preferred.
Supervision
The Claims Auditor will report directly to the Compliance Manager.
  • This is a full-time position.
  • This position is remote, with occasional travel to the corporate office.
Essential Job Duties
  • Perform routine internal audits of pharmacy claims to ensure billing accuracy, proper documentation, and compliance with federal, state, PBM, and company requirements.
  • Review submitted and adjudicated claims to confirm that key claim elements are accurate, including patient information, prescriber details, medication, quantity, day supply, DAW codes, origin codes, insurance billing, and supporting documentation.
  • Identify, investigate, and document claim discrepancies, billing irregularities, documentation deficiencies, refill timing concerns, override issues, cash billing variances, and other potential audit risks.
  • Ensure claims are properly supported by required documentation, including hardcopy notes, signatures, delivery records, claim history, payer communication, rebill notes, reversal activity, and override documentation.
  • Monitor pharmacy billing practices to help reduce audit exposure, chargebacks, and compliance concerns.
  • Track audit findings and identify patterns or recurring issues that may point to workflow, training, or process gaps.
  • Communicate audit results, trends, and potential risks to the Compliance Manager, pharmacy leadership, and operational teams.
  • Partner with pharmacy teams and operational leadership to help correct claim issues, strengthen front-end workflows, and improve overall audit readiness.
  • Develop reports and summaries that show claim accuracy, audit trends, correction timelines, recurring errors, and opportunities for improvement.
  • Support training and education for pharmacy staff on insurance requirements, documentation expectations, billing practices, and audit readiness.
  • Participate in cross-training, peer review, and process improvement efforts to support consistency across pharmacy locations.
  • Maintain professionalism, confidentiality, and integrity in all audit-related activities.
Qualifications
  • Medical billing auditing experience
  • Pharmacy auditing or pharmacy technician experience preferred
  • Applies Growth Mindset - Actively seeking new ways to grow and be challenged.
  • Demonstrates a deep understanding of the pharmacy regulations.
  • Thinks and acts strategically.
  • Ensures Outcomes - minimizes company exposure to outside auditors and regulators.
  • Participates actively within a High Performing Teams.
  • Engages and inspires other
  • Communicates to ensure readiness to execute programs
Benefits
  • Work for an engaging and growing company.
  • Health and vision insurance.
  • Dental insurance.
  • Paid time off.
  • 401(k) with employer matching.
  • Competitive salary.
  • Performance-based bonus eligibility, if applicable.
Schedule
  • Full-time position.
  • Remote work setting.
  • Occasional travel to the corporate office may be required.
  • Monday to Friday schedule anticipated.

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