CVS Health

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Pharmacy Claims Auditor

at CVS Health

Posted: 8/10/2018
Job Reference #: 846758BR
Keywords:

Job Description

Job Title :
Pharmacy Claims Auditor
Job ID :
846758BR
Location :
AZ - Scottsdale
Street Address :
9501 E Shea Blvd
Category :
Audit
Description :
Job Description
The Pharmacy Claims Auditor is responsible for reviewing pharmacy claims submitted through the CVS Health claims processing systems. The Pharmacy Claims Auditor will identify and rectify claims inaccuracies that would result in client over-payment.

As a Pharmacy Claims Auditor, you will:
- Contact pharmacies for proper documentation to ensure a claim was submitted correctly
- In the event of an inaccurate claim submission, follow the appropriate Policies & Procedures to get claims resubmitted in a timely manner
- Monitor assigned clients and report status on a regular basis
- Work closely with internal and external customers to directly impact departmental success

Required Qualifications
1+ years of professional experience, preferably in a retail pharmacy setting

Preferred Qualifications
- Knowledge of LTC and PBM industries
- 2+ years of Pharmacy experience
- Knowledge of CVS Health (or other Pharmacy Benefit Management) claims processing systems
- Excellent verbal and written communication skills
- Ability to work and make decisions independently with a self-starter mentality

Education
High school diploma or GED required; Bachelor's Degree preferred

Business Overview
CVS Health, through our unmatched breadth of service offerings, is transforming the delivery of health care services in the U.S. We are an innovative, fast-growing company guided by values that focus on teamwork, integrity and respect for our colleagues and customers. What are we looking for in our colleagues? We seek fresh ideas, new perspectives, a diversity of experiences, and a dedication to service that will help us better meet the needs of the many people and businesses that rely on us each day. As the nation’s largest pharmacy health care provider, we offer a wide range of exciting and fulfilling career opportunities across our three business units - MinuteClinic, pharmacy benefit management (PBM) and retail pharmacy. Our energetic and service-oriented colleagues work hard every day to make a positive difference in the lives of our customers.

CVS Health is an equal opportunity employer. We do not discriminate in hiring or employment against any individual on the basis of race, ethnicity, ancestry, color, religion, sex/gender (including pregnancy), national origin, sexual orientation, gender identity or expression, physical or mental disability, medical condition, age, veteran status, military status, marital status, genetic information, citizenship status, unemployment status, political affiliation, or on any other basis or characteristic prohibited by applicable federal, state or local law. CVS Health will consider qualified job candidates with criminal histories in a manner consistent with federal, state and local laws. CVS Health will not discharge or in any other manner discriminate against any Colleague or applicant for employment because such Colleague or applicant has inquired about, discussed, or disclosed the compensation of the Colleague or applicant or another Colleague or applicant. Furthermore, we comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW and EEO IS THE LAW SUPPLEMENT

Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. If you require assistance to apply for this job, please contact us by clicking Advice and Counsel

CVS Health does not require nor expect that applicants disclose their compensation history during the application, interview, and hiring process.

For inquiries related to the application process or technical issues please contact the Kenexa Helpdesk at 1-855-338-5609. For technical issues with the Virtual Job Tryout assessment, contact the Shaker Help Desk at 1-877-987-5352. Please note that we only accept resumes via our corporate website: https://jobs.cvshealth.com/

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!