Pharmacy Claims Auditor
3 weeks ago
Pharmacy Claims Auditor – Integrated Pharmacy Solutions Location: Melrose, MA, Boston area Employment type: Full-time Seniority level: Entry level Industry: Pharmaceutical Manufacturing Salary: $56,000 – $62,000 per year (based on skills and experience) Travel: Must travel 50% of time in the continental U.S. for onsite audit trips. Responsibilities Schedule and prepare for onsite audit trips Review pharmacy prescriptions for compliance to State and Federal regulations Enter potential discrepancies into the IPS audit software Complete store credentialing worksheet Explain audit findings and recommend solutions Must be willing to travel in the continental U.S. 50% of the time. Skills Knowledge of the most common medications and usual dosages Understanding of methods of filling prescriptions and submitting claims Experience with third party (insurance) billing procedures Interpreting prescriptions accurately Ability to analyze large amount of pharmacy claims data Awareness of pharmacy prescription laws and regulations Attention to details, accuracy and quality Computer proficient in Microsoft Office products as well as pharmacy computer systems Excellent verbal and written communication skills Sound judgement and decision-making ability Strong organizational skills Keen attention to detail Ideal candidates must be able to work independently, be self-motivated, have good organizational skills and excellent customer service skills. Ability to identify issues, investigate matters and creatively work to resolve unexpected and unanticipated problems. Fifty percent travel in the continental U.S. is required. Qualified candidates must be a registered Pharmacy Technician in Massachusetts and ideally have 3 plus years’ experience as a Nationally Certified Pharmacy Technician. #J-18808-Ljbffr
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Pharmacy Claims Auditor
1 hour ago
Boston, United States Massachusetts Staffing Full timePharmacy Claims Auditor - Remote At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. The Pharmacy Claims Auditor is responsible for identifying and evaluating potential waste and...
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Claims Auditor I, II
4 weeks ago
Boston, United States Massachusetts Staffing Full timeClaims Auditor I, II, and Senior This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our...
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Claims Auditor Property
2 weeks ago
Boston, United States Alan Gray - A Premia Reinsurance Company Full timeClaims Auditor Property (Temporary/Project Based) Job Description Alan Gray LLC is a leading audit and advisory firm with over 30 years of excellence in providing a range of services to insurance-industry clients. Our goal is to help our clients realize significant bottom-line savings. Our experienced team is committed to staying current with the latest...
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Claims Auditor Property
2 weeks ago
Boston, United States Alan Gray - A Premia Reinsurance Company Full timeClaims Auditor Property (Temporary/Project Based) Job Description Alan Gray LLC is a leading audit and advisory firm with over 30 years of excellence in providing a range of services to insurance-industry clients. Our goal is to help our clients realize significant bottom-line savings. Our experienced team is committed to staying current with the latest...
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Senior Claims Auditor, Medical Stop Loss
2 weeks ago
Boston, United States Berkshire Hathaway Specialty Insurance Full timeJob Opportunity Berkshire Hathaway Specialty Insurance (BHSI) has an exciting opportunity for a Medical Stop Loss Senior Claims Auditor with knowledge of employer group health insurance, managed care, and direct medical claims products. This position will work with our Third-Party Administrators (TPAs) daily with interaction with several other areas in our...
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Senior Claims Auditor, Medical Stop Loss
2 weeks ago
Boston, United States Berkshire Hathaway Specialty Insurance Full timeJob Opportunity Berkshire Hathaway Specialty Insurance (BHSI) has an exciting opportunity for a Medical Stop Loss Senior Claims Auditor with knowledge of employer group health insurance, managed care, and direct medical claims products. This position will work with our Third-Party Administrator’s (TPA’s) daily with interaction with several other areas in...
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Inventory Auditor
9 hours ago
Boston, MA, United States ADEX Full timeOur customer provides inventory services to the healthcare delivery industry. They audit inventories of medical, surgical, and pharmaceutical products as well as capital and patient care equipment. Our brand is our professionalism, accuracy, and punctuality. The team is an extension of our customers' supply chain and pharmacy operations team. Compliance with...
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Inventory Auditor
5 days ago
Boston, MA, United States ADEX Full timeOur customer provides inventory services to the healthcare delivery industry. They audit inventories of medical, surgical, and pharmaceutical products as well as capital and patient care equipment. Our brand is our professionalism, accuracy, and punctuality. The team is an extension of our customers' supply chain and pharmacy operations team. Compliance with...
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Premium Auditor
3 weeks ago
Boston, United States Davies North America Full time3 days ago Be among the first 25 applicantsGig Workers Wanted!Are you tired of working for someone else? Have you thought about building a business for yourself? If you answered yes to either question – Welcome! We are excited to introduce Davies Risk Services to you!Gig Workers Wanted!Are you tired of working for someone else? Have you thought about...
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Auditor
3 weeks ago
Boston, United States Massachusetts Staffing Full timeAuditor PositionSummary: Conducting audits in support of investigations and litigation involving the government's affirmative civil enforcement of federal laws. Reviewing, auditing, and understanding complex data, including Centers for Medicare & Medicaid claims data and PPP loan data, and activities of entities and individuals involved in health care fraud,...
