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

📋 Description

• Execute designated pharmacy desk audits by evaluating prescription claims and associated documentation for compliance as well as identifying potential discrepancies or overpayments.

• Analyze pharmacy records and documentation, which includes prescription records, signature logs, proof of delivery, invoices, and dispensing records.

• Implement audit procedures, client specifications, discrepancy codes, and validation criteria to pinpoint supported claims and recoverable findings.

• Ensure comprehensive and timely audit documentation, including case notes, evidence, findings, and status updates.

• Conduct quality review and validation tasks for the assigned pharmacy audits.

• Perform onsite or virtual pharmacy audits, which encompass interactions with pharmacy personnel, record reviews, evidence collection, and documentation of findings.

• Liaise with Audit Coordinators, management, and internal stakeholders regarding audit status, issues, findings, deadlines, and necessary escalations.

• Stay informed about pharmacy audit requirements, client policies, pharmacy practices, and both state and federal regulations.

• Manage pharmacy and patient information in accordance with HIPAA, confidentiality, privacy, and information-security mandates.

• Carry out additional pharmacy audit-related responsibilities as assigned.