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Pharmacy Auditor
TX - Irving
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We currently have an opening for:Pharmacy AuditorJob Duties:
Conduct all aspects of On-Site Reviews (OSR) for various clients throughout the U.S.
Forensic claims analysis for pharmacy selection
Identify potential fraudulent activity through claims analysis
Forensic analysis for claims selection
Departmental research to develop and incorporate enhancements to systems to assist in identifying possible fraudulent/devious activity
Analysis and interpretation of on-site audit results to determine final recommendations to clients
Attend client meetings as required to discuss any aspects of an on-site review
Create detailed written reports containing audit findings
Research and interpret State Board of Pharmacy Laws
Research State Audit Bill of Rights requirements as they pertain to on-site audits
Perform Focused Investigation Audits as needed/requested
Job Requirements:
Licensed Technician (CPhT preferred) with minimum of 3 years experience with pharmacy billing required in retail, hospital, home infusion, mail service, specialty drug and/or long term care pharmacy operations.
Minimum two years pharmacy auditing experience preferred.
Knowledge of state board of pharmacy laws and regulations
Knowledge of CMS initiatives and requirements preferred
Computer skills and experience with Access, Word, Excel
Excellent written and oral communication skills
Problem solving, analytical ability, communication skills, interpersonal skills
We currently have an opening for:Pharmacy AuditorJob Duties:
Conduct all aspects of On-Site Reviews (OSR) for various clients throughout the U.S.
Forensic claims analysis for pharmacy selection
Identify potential fraudulent activity through claims analysis
Forensic analysis for claims selection
Departmental research to develop and incorporate enhancements to systems to assist in identifying possible fraudulent/devious activity
Analysis and interpretation of on-site audit results to determine final recommendations to clients
Attend client meetings as required to discuss any aspects of an on-site review
Create detailed written reports containing audit findings
Research and interpret State Board of Pharmacy Laws
Research State Audit Bill of Rights requirements as they pertain to on-site audits
Perform Focused Investigation Audits as needed/requested
Job Requirements:
Licensed Technician (CPhT preferred) with minimum of 3 years experience with pharmacy billing required in retail, hospital, home infusion, mail service, specialty drug and/or long term care pharmacy operations.
Minimum two years pharmacy auditing experience preferred.
Knowledge of state board of pharmacy laws and regulations
Knowledge of CMS initiatives and requirements preferred
Computer skills and experience with Access, Word, Excel
Excellent written and oral communication skills
Problem solving, analytical ability, communication skills, interpersonal skills
HMS is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status.
