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Third Party Audit Coordinator

at CVS Health

Posted: 1/16/2020
Job Reference #: 1181247BR
Keywords: financial

Job Description

Job Description
The Third Party Audit Coordinator requires a person with solid communication skills, both written and oral. The candidate should have solid organizational, interpersonal and time management skills. They will be required to resolve and complete Third Party audit requests while executing project ownership for 1+ concurrent department projects. In addition the Third party Audit Coordinator will maintain the following principle responsibilities:

Principle Responsibilities:
- Perform many different audits while assisting pharmacy staff and field management to resolve and complete audit requests and inquiries. Closely monitor current processes and SOP’s to maximize efficiency and drive innovation.
- Ability to digest shifts in work assignments to account for seasonal workload shift or unforeseen events impacting daily workload
- Provide timely and accurate documentation to support the administration of prescription claims to the PBM or Plan in accordance with HIPAA and audit client requirements.
- Evaluate audit discrepancies against BOP, State/Federal and Payer contract language to ensure audit results comply with required guidelines.
- Ability to self-report on audit trend analysis and provide insight to management for operational or financial considerations. Ability to analyze trends and develop strategies to ensure continuous improvement of results.
- Coordinate audit activities with audit clients and interact with store support and management staff while maintaining departmental goals, policies and initiatives.
- Perform accurate and timely data entry and data movement into internal reporting tools and databases.
- Take prompt action to review, diagnose and understand new audit requests
- Communicate with audit payers, firms and internal departments on audit activities & observations
- Perform timely resolution to requests received from internal departments, customers, audit entities, or regulatory agencies.
- Promotes a cooperative and respective relationship with other personnel, entities or agencies while maintaining professionalism at all times
- Motivated to identify ways to improve audit process and results influencing downstream financial results for Third Party Department
- Possess project management skills to drive improvement in key department metrics
- Ability to work under pressure with minimal supervision and demonstrates excellent decision making skills
- Demonstrates professional growth through independent study, training, and certificate opportunities

Required Qualifications
1+ years of professional work experience, preferably in a corporate healthcare or pharmacy setting
1+ years of MS Office experience

Preferred Qualifications
-Pharmacy technician experience preferred
-Excellent verbal and written communication skills and the ability to interact professionally with a diverse group directors, managers, colleagues, and external customers.
- Driven and self-motivated to perform at a high level.
- Ability to prioritize, structure timelines and project plans, engage and align stakeholders across multiple groups, define measures of success, incorporate feedback and analyze results across multiple work streams
- High level of independent judgment and initiative.
- Excellent critical thinking, organizational and time management skills with a strong attention to detail, accuracy, and follow through.
- Ability to complete routinely assigned work based on productivity standards (SLA) with minimal supervision
- Previous experience consisting of auditing, healthcare, compliance, claims processing, account management, project management, retail pharmacy or PBM experience

Verifiable High School Diploma or GED required. Bachelor’s degree highly preferred

Business Overview
It’s a new day in health care.

Combining CVS Health and Aetna was a transformative moment for our company and our industry, establishing CVS Health as the nation’s premier health innovation company. Through our health services, insurance plans and community pharmacists, we’re pioneering a bold new approach to total health. As a CVS Health colleague, you’ll be at the center of it all.

We offer a diverse work experience that empowers colleagues for career success. In addition to skill and experience, we also seek to attract and retain colleagues whose beliefs and behaviors are in alignment with our core values of collaboration, innovation, caring, integrity and accountability.

CVS Health is an equal opportunity/affirmative action employer. Gender/Ethnicity/Disability/Protected Veteran - we highly value and are committed to all forms of diversity in the workplace. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities. 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. We provide reasonable accommodations to qualified individuals with disabilities. If you require assistance to apply for this job, please contact our Advice and Counsel Reasonable Accommodations team. Please note that we only accept applications for employment via this site.

If technical issues are preventing you from applying to a position, contact Kenexa Helpdesk at 1-855-338-5609 or For technical issues with the Virtual Job Tryout assessment, contact the Shaker Help Desk at 1-877-987-5352.

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!