340B Compliance Auditor I

This is a fully remote position, open to applicants in Pennsylvania.

📋 Description

• Develop a thorough understanding of the 340B Program and offer expert guidance on audits to staff and management.

• Stay updated on 340B-eligible sites, contract pharmacy networks, and 340B purchasing protocols.

• Perform precise and effective audits to identify risks and prevent duplicate discounts and diversion.

• Review and contribute to the policies and procedures related to 340B to ensure adherence to compliance standards.

• Collaborate with the 340B Program Manager, 340B Program Director, and various stakeholders.

• Lead extensive 340B audits and internal control assessments.

• Support the departmental revenue cycle and other critical initiatives.

• Ensure adherence to 340B drug purchasing regulations and conduct monthly audits.

• Maintain the split-billing software and carry out basic crosswalk maintenance.

• Execute audits for contract pharmacy, mixed-use, spot, and compliance purposes.

• Address and resolve reconciliation issues during the monitoring and reconciliation process.

• Assess patient eligibility and review relevant medical records.

• Monitor drug purchases related to GPO, WAC, and 340B accounts.

• Engage with wholesalers, vendors, information system service providers, insurance companies, pharmacies, internal departments, medical providers, and external auditors.

• Oversee compliance across various 340B points of service.

• Review processes to mitigate risk and prevent duplicate discounts or diversion.

• Conduct compliance evaluations of charge descriptions, utilization data, and reorder reporting.

⛳️ Requirements

• High School Diploma or Equivalent (GED) (Required).

• A minimum of 2 years of relevant work experience (Required).

• Familiarity with 340B drug purchasing and federal 340B regulations.

• Experience with monthly auditing, maintenance of split-billing software, and audits related to contract pharmacy and mixed-use.

• Capability to assess patient eligibility through medical records, insurance plans, and hospital admission status.

• Proficiency in conducting chart and medical record reviews.

• Ability to verify patient, provider, and medication information for claim submissions.

• Competence in monitoring GPO, WAC, and 340B drug purchases.

• Skills in Business Analysis.

• Strong Critical Thinking abilities.

• Knowledge of the Healthcare Industry.

• Proficiency in Microsoft Excel.

🏝️ Benefits

• Healthcare benefits available for both full-time and part-time positions starting from day one.

• Vision coverage.

• Dental coverage.

• Benefits for domestic partners.

• A collaborative, cooperative, and collegial work environment.