Data Validation Audit Specialist

Job Summary

A company is looking for a Data Validation Audit Specialist to support clients by analyzing pharmacy claims data and ensuring compliance with contract requirements.

Key Responsibilities

• Execute Medicare Part C & D Data Validation audits and ensure compliance with CMS reporting requirements
• Conduct data analysis for various CMS and PBM audits, generating reports and consulting with clients on findings
• Manage project timelines and collaborate with team members while mentoring junior staff

Required Qualifications

• 3 to 5 years of experience in healthcare or pharmacy benefit management, focusing on pharmacy claims processing
• Ability to build and maintain collaborative working relationships across business units
• Proficient in MS Office Suite
• High level of confidentiality and ethical standards
• Associate degree or higher preferred, along with direct PBM claims auditing experience