Job Category: Audit
Clinical Licensure Required : Pharmacy Technician
Job Type: Full Time Position Summary:
This candidate is responsible for the review of pharmacy claims submitted through the CVS/Caremark claims processing system. The purpose of the review is to identify and rectify claim inaccuracies that would result in client overpayment. Position is an integral part of pharmacy claims audit process and requires a detail oriented candidate. The candidate is, among other things, responsible for contacting the pharmacy for proper documentation or resubmission of inaccurate claim information in a timely manner. Candidate is required to monitor assigned clients and report status on a regular basis. Candidate works closely with internal and external customers and directly impacts the departmental success Required Qualifications:
0-3 years relevant Pharmacy Benefit Management or Pharmacy claims experience. Knowledge of CVS/Caremark (or other pharmacy benefit management) claims processing system. Excellent communication skills. Knowledge of LTC and PBM industry. Preferred Qualifications:
Ability to work and make decisions independently with a self-starter mentality Education:
Bachelor's Degree required, or two years of relevant experience for every one year of college not completed. Business Overview:
CVS Caremark, 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 - 2 years ago
CVS Health (NYSE: CVS) is a pharmacy innovation company helping people on their path to better health. Through our 7,700 retail pharmacies,...