About the Company
CVS Health is a leading healthcare company that delivers innovative solutions to improve health and make healthcare more accessible. From our retail pharmacies to our pharmacy benefit management services and health insurance plans, we are committed to helping people on their path to better health. We foster a culture of integrity, collaboration, and continuous improvement, valuing diversity and inclusion in every aspect of our operations.
Job Description
We are seeking a highly meticulous and detail-oriented Pharmacy Auditing Clerk to join our remote team. This role is critical in ensuring the accuracy and compliance of pharmacy claims and records, directly contributing to our operational efficiency and patient care standards. The ideal candidate will possess exceptional organizational skills, a keen eye for discrepancies, and a commitment to maintaining high standards of data integrity. This is a remote-first position, allowing you to work from anywhere within the US.
Key Responsibilities
- Perform comprehensive audits of pharmacy claims, prescriptions, and billing records to ensure accuracy and compliance with internal policies and regulatory requirements.
- Identify and investigate discrepancies, errors, and potential fraud or waste, reporting findings to senior auditors.
- Reconcile audit findings with pharmacy data systems and make necessary adjustments or recommendations.
- Maintain detailed and organized documentation of all audit activities and findings.
- Collaborate with internal teams, including pharmacists, billing specialists, and compliance officers, to resolve audit-related issues.
- Assist in the preparation of audit reports and summaries for management review.
- Stay updated on changes in pharmacy regulations, billing codes, and industry best practices.
Required Skills
- High school diploma or equivalent
- Proven ability to maintain high levels of accuracy and attention to detail
- Proficiency in Microsoft Office Suite (Excel, Word, Outlook)
- Strong analytical and problem-solving skills
- Excellent written and verbal communication skills
- Ability to work independently and manage time effectively in a remote environment
Preferred Qualifications
- Associate's or Bachelor's degree in a related field (e.g., healthcare administration, business)
- Previous experience in pharmacy operations, medical billing, or auditing
- Familiarity with pharmacy management software or claims processing systems
- Knowledge of healthcare compliance standards (e.g., HIPAA) and pharmacy regulations
Perks & Benefits
- Comprehensive health, dental, and vision insurance
- 401(k) retirement plan with company match
- Paid time off and company holidays
- Employee assistance program
- Opportunities for professional development and career growth
- Remote work flexibility with a supportive virtual team environment
How to Apply
If you are interested in this position, please click the "Apply Now" button below. To ensure your application is properly considered, please prepare the following:
- An up-to-date Resume or CV
- A brief cover letter summarizing your experience and motivation
Applications are reviewed on a rolling basis. Only shortlisted candidates will be contacted for an interview.
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