Pharmacy Claims Auditor - Senior Consultant in Scottsdale, Arizona | DiversityInc Careers

Pharmacy Claims Auditor - Senior Consultant

Job DescriptionThe Daily Review team is responsible for reviewing pharmacy claims utilizing multiple programs and working with various third party contacts to collect proper documentation to ensure a pharmacy claim was submitted correctly.

As a Pharmacy Claims Auditor - Senior Consultant on the Daily Review team, you will:

- Perform weekly quality checks for the Daily Review process
- Monitor claims and report trends on a regular basis
- Train new employees and provide on-going support and training to the team as needed
- Work closely with internal and external customers to directly impact departmental success
- Assist on ad hoc projects and other tasks as assignedRequired Qualifications- 5+ years of professional experience, preferably in a retail pharmacy settingPreferred 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 mentalityEducationHigh school diploma or GED required; Bachelor's Degree preferredBusiness OverviewCVS 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:
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