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(Pharmacy Technician) Claims Auditor

EnvisionRx Fort Lauderdale, FL
  • Expired: over a month ago. Applications are no longer accepted.

(Pharmacy Technician) Claims Auditor

The Claims Auditor is responsible for assisting in the execution of pharmacy claims auditing to detect and resolve client fraud, waste, and abuse (FWA) accurately.

Department: Compliance-Audit Services

ESSENTIAL DUTIES AND RESPONSIBILITIES:

  • Perform analysis of prescriptions and other pharmacy related documentation to verify accuracy and validity of billed claims. Accurately document findings.
  • Research and analyze data related to pharmacy claims
  • Compile documentation in relation to pharmacy claims audits as it relates to departmental activities
  • Maintain accurate documentation of pharmacy audit (or project) progress in order to provide accurate and timely feedback to Supervisory personnel
  • Accurate maintenance and organization of contact database and audit documentation
  • Communicate with doctors, pharmacies and patients, according to audit needs
  • Assist with research and assembly of reporting documents for clients, CMS, and internal use
  • Develop and report department audit results
  • Other duties as assigned

REQUIREMENTS:

  • High school diploma or GED
  • Certified, Licensed, or Registered Pharmacy Technician
  • Pharmacy technician experience
  • Strong attention to detail and accuracy
  • Effective verbal and written communication skills
  • An excellent facilitator who is experienced in resolving conflicts between different parties to a dispute
  • A decisive individual who possesses a detail oriented perspective
  • Demonstrated ability to manage multiple priorities and deadlines
  • A well-organized and self-directed individual who is able to work with minimal amount of supervision
  • Capability to efficiently complete tasks in a fast paced environment
  • Proficient in Microsoft Office and industry related software programs
  • Ability to work extended hours, weekends, and holidays pursuant with industry demands

PREFERRED QUALIFICATIONS:

  • Bachelor’s degree in health administration, health sciences or related field

  • Demonstrated pharmacy claims auditing experience

  • Medicare Part D knowledge

  • Pharmacy claims analysis experience

  • Bilingual in English and Spanish

  • PBM experience

  • Ability to work with peers in a team effort

  • Demonstrated ability to manage multiple priorities and deadlines

Pre-employment drug screening and background checks are required. The company offers a competitive salary and benefits package. EOE. All qualified applicants receive consideration for employment without regard to race, color, religion, sex, national origin, disability or veteran status.

EnvisionRxOptions is committed to maintaining a productive, drug-free workplace that keeps employees and customers safe from harm.

EnvisionRx

Why Work Here?

Great Benefits:Medical, Dental, Vision, PTO, Tuition Reimbursement upto $5,250.00 & up to 9% $ to $ 401K match!

EnvisionRx, with a commitment to providing transparency and disclosure to the Pharmacy Benefit Management (PBM) marketplace, provides full service, integrated PBM services, including network-pharmacy claims processing, mail order, benefit design consultation, drug utilization review, formulary management, and other related services. If you are interested in becoming part of a team-oriented, fast-growing company we encourage you to consider a satisfying career at EnvisionRx. Pre-employment drug screening and background checks are required. The company offers a competitive salary and benefits package. EOE. All qualified applicants receive consideration for employment without regard to race, color, religion, sex, national origin, disability or veteran status. EnvisionRxOptions is committed to maintaining a productive, drug-free workplace that keeps employees and customers safe from harm.

Address

Fort Lauderdale, FL
33308 USA