Pharmacy Claims Audit Specialist, CPhT Required (Hybrid Work Environment)

Track, research, and resolve processor claims audits received by the company from various third-party agencies within strict deadlines.
Communicate with divisions, pharmacies, and insurance companies to reduce the number of claims that are recouped from the company.
Demonstrate the company s core values of respect, honesty, integrity, diversity, inclusion and safety.
Minimum - Self-starter with ability to perform job responsibilities minimal supervision - Physical ability to access all necessary files - Must be highly organized and detail oriented and able to function effectively in a multi-task environment - Ability to work within strict deadlines - Must be able to use discretion and maintain confidential information - Ability to work well with others - Strong analytical skills - Good written and oral communication and customer service skills - Working knowledge of Microsoft Office, including Excel Desired - Basic insurance knowledge and Medicare/ Medicaid knowledge - Knowledge of third-party operations and accounts receivable - Knowledge of Pharmacy store systems (EasyFill PRN)- Research and track third-party processor audits for assigned divisions/processors - Maintain all incoming notices, original audit balances, final results, and ending recoupment activity for assigned audits - Enter all audit information into the pharmacy accounting system for reporting and tracking - Ensure audit deadlines are met and stores comply with audit notices; dispute any necessary items as required - Research/respond to agency/store/division inquiries or questions regarding third-party processor audits - Coordinate rebilling work with the aging team as needed - Provide timely accurate communication of information and accounting to the divisions regarding audit loss - Must be able to perform the essential job functions of this position with or without reasonable accommodation