Job Openings
Pharmacy Claims Coordinator
About the job Pharmacy Claims Coordinator
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.