Pharmacy Benefit Auditor (CPhT)

Job Summary

A company is looking for a Pharmacy Benefit Auditor to join their team remotely.

Key Responsibilities

• Conduct data analysis for pharmacy benefit and contractual audits related to pharmacy claims
• Gather and implement audit rules and requirements from clients and PBMs into proprietary systems
• Generate audit reports and consult with clients on findings while managing multiple projects simultaneously

Required Qualifications, Training, and Education

• Pharmacy Technician Certification (CPhT) and/or pharmacy work experience
• Associate degree or higher (preferred)
• 3 to 5 years of experience in healthcare or health insurance with a focus on pharmacy claims processing
• Direct PBM claims auditing experience within a PBM and/or Health Plan (preferred)
• Ability to maintain a high level of confidentiality