About the Company
OptumRx, a leading pharmacy benefit manager, is dedicated to helping people live healthier lives and helping make the health system work better for everyone. We’re part of Optum and UnitedHealth Group, providing innovative solutions and services across the pharmacy care continuum. Our team is committed to accuracy, efficiency, and exceptional service in managing prescription benefits.
Job Description
We are seeking a highly detail-oriented and meticulous Pharmacy Auditing Clerk to join our team. This is a crucial remote role focused on ensuring the accuracy and compliance of pharmacy claims and transactions. The ideal candidate will possess exceptional analytical skills, a strong commitment to accuracy, and the ability to work independently in a fast-paced environment. You will be responsible for reviewing, verifying, and auditing pharmacy claims, identifying discrepancies, and ensuring adherence to regulatory guidelines and internal policies.
Key Responsibilities
- Perform comprehensive audits of pharmacy claims to identify errors, discrepancies, and non-compliance issues.
- Verify prescription data, billing codes, and patient information against established protocols.
- Communicate findings and collaborate with internal teams to resolve identified issues promptly and accurately.
- Maintain detailed and organized records of all audit activities and findings.
- Assist in the development and improvement of auditing processes and procedures.
- Stay updated on industry regulations, company policies, and best practices related to pharmacy claims and auditing.
- Handle sensitive information with the utmost confidentiality and professionalism.
Required Skills
- Exceptional attention to detail and accuracy.
- Strong analytical and problem-solving skills.
- Proficiency in data entry and record-keeping.
- Excellent written and verbal communication skills.
- Ability to work independently and manage time effectively in a remote setting.
- Proficient with Microsoft Office Suite, especially Excel.
- High school diploma or equivalent.
Preferred Qualifications
- Associate's degree in a related field.
- 1+ year of experience in pharmacy operations, claims processing, or auditing.
- Familiarity with medical terminology and pharmacy benefit management (PBM) processes.
- Experience with pharmacy management software or claims adjudication systems.
Perks & Benefits
- Competitive salary and performance bonuses.
- Comprehensive health, dental, and vision insurance.
- 401(k) retirement plan with company match.
- Paid time off and holiday pay.
- Opportunities for professional development and career advancement.
- Employee assistance program.
- Remote work flexibility.
- Wellness programs and resources.
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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