Pharmacy Audit Support Representative
2 weeks ago
Join to apply for the Pharmacy Audit Support Representative role at Comercial Navero y Elvira Pol. Ind. Postuero - Nave 7-8 About The Role We are seeking a Pharmacy Audit Support Representative to join our team. This role is responsible for reviewing and analyzing pharmacy claims to ensure compliance with regulations and company standards. The position involves working closely with pharmacy providers, verifying claims data, identifying discrepancies, and supporting audit processes to maintain the accuracy and integrity of our claims systems. Responsibilities Review pharmacy claims against company policies and regulatory guidelines to identify errors or potential fraud. Communicate with pharmacy providers to verify billing details and request claim adjustments when necessary. Document audit support findings, prepare reports, and maintain accurate records of communications. Review prescriptions, dispensing activities, and supporting documents for billing accuracy. Escalate compliance concerns, including cases of suspected fraud, waste, or abuse. Prepare correspondence and coordinate with internal teams to support the provider audit process. Participate in special projects, reporting, and problem resolution activities. Qualifications High school diploma (or equivalent) required; Associate degree or college coursework preferred. At least 1 year of experience in a pharmacy setting and 1 year of administrative or customer service experience. Working knowledge of Microsoft Office (Word, Excel) and familiarity with database systems. Pharmacy Technician license or certification is an advantage but not required. Strong knowledge of pharmacy practices, prescription interpretation, and standard medication dosages. Excellent communication skills (verbal and written) with the ability to manage sensitive provider interactions. Highly organized, detail-oriented, and capable of working independently. What We're Looking For Adaptability and problem-solving skills in fast-paced environments. Strong professionalism, customer focus, and commitment to accuracy. Ability to handle multiple priorities and meet deadlines. Work Environment Standard office hours: Monday to Friday, 8:00am–5:00pm (overtime or weekend work may occasionally be required). This role may involve limited travel depending on business needs. Seniority level Not Applicable Employment type Full-time Job function Other Industries Individual and Family Services #J-18808-Ljbffr
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Pharmacy Claims Coordinator
2 weeks ago
Cebu City, Philippines Comercial Navero y Elvira Pol. Ind. Postuero - Nave 7-8 Full timeOverview We\'re looking for a Pharmacy Claims Auditor to safeguard our claims data and prevent fraud. You\'ll conduct audits, analyze billing activities, and ensure compliance with regulations. What Youll Do Conduct desk and on-site pharmacy audits. Review claims for errors, discrepancies, or fraud. Communicate with pharmacies to resolve billing issues....
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Pharmacy Claims Compliance Specialist
2 weeks ago
Cebu City, Central Visayas, Philippines KMC Solutions Full time ₱900,000 - ₱1,200,000 per yearJob Overview:Work on-site at our Cebu officeNight shiftPharmacy degree (Pharm. D.) or equivalent; and 2+ years related retail experience and/or training; or equivalent combination of education and experience.Essential Duties and Responsibilities include the following. Other duties may be assigned.Prepares and completes retrospective desktop, and targeted...
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Customer Support Representative
4 weeks ago
Cebu City, Philippines Select VoiceCom Full timeOverview As a Customer Support Representative, you will be supporting people in the US and assisting them in managing pharmacy prescription benefits. Responsibilities Assisting customers in managing prescription benefits, handling processing issues, and acquiring savings cards Assisting clients in understanding their target copay and available pharmacy...
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Cebu City, Philippines KMC Solutions Full timeJob Overview Work on-site at our Cebu office Night shift Pharmacy degree (Pharm. D.) or equivalent; and 2+ years related retail experience and/or training; or equivalent combination of education and experience. Essential Duties and Responsibilities Prepares and completes retrospective desktop, and targeted audits, including obtaining claim data for analysis,...
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Pharmacist and Area Sales Representative
1 week ago
Cebu City, Philippines Immuni Global Incorporated Full timePharmacist and Area Sales Representative Immuni Global is looking for a Licensed Pharmacist to take on a dynamic role as Area Sales Representative . This position combines your professional pharmacy expertise with sales and retail execution responsibilities. You will manage your assigned territory, ensuring optimal product availability, visibility, and...
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Pharmacy Assistant
3 days ago
Malolos City P, Philippines ACE MALOLOS DOCTORS INC. Full time ₱169,200 per yearJOB SUMMARY:The Pharmacy Assistant provides support to licensed pharmacists in the preparation, dispensing, and management of medications and supplies. The role ensures that pharmacy operations are conducted safely, efficiently, and in compliance with regulatory standards. Possession of an NC III certification ensures competency in handling pharmaceutical...
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Customer Support Representative
4 weeks ago
Cebu City, Philippines SVCPH Inc. Full timeOverview What you’ll do: As a Customer Support Representative, you will be supporting people in the US and assisting them in managing pharmacy prescription benefits. Responsibilities Assisting customers in managing prescription benefits, handling processing issues, and acquiring savings cards Assisting clients in understanding their target copay and...
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Customer Support Representative
3 weeks ago
Cebu City, Philippines Select VoiceCom Full timeWhat you’ll do: As a Customer Support Representative, you will be supporting people in the US and assisting them in managing pharmacy prescription benefits. Responsibilities include: Assisting customers in managing prescription benefits, handling processing issues, and acquiring savings cards Assisting clients in understanding their target copay and...
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Pharmacist and Area Sales Representative
2 weeks ago
Cebu City, Central Visayas, Philippines Immuni Global Incorporated Full time ₱300,000 - ₱600,000 per yearPosition SummaryImmuni Global is looking for aLicensed Pharmacistto take on a dynamic role asArea Sales Representative. This position combines your professional pharmacy expertise with sales and retail execution responsibilities. You will manage your assigned territory, ensuring optimal product availability, visibility, and merchandising compliance while...
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Customer Support Representative
1 week ago
Cebu City, Central Visayas, Philippines Select VoiceCom Full time ₱15,000 - ₱30,000 per yearWhat you'll do:As a Customer Support Representative, you will be supporting people in the US and assisting them in managing pharmacy prescription benefits.Responsibilities include:Assisting customers in managing prescription benefits, handling processing issues, and acquiring savings cardsAssisting clients in understanding their target copay and available...
