Pharmacy Audit Support Representative

7 days ago

Cebu City, Philippines Comercial Navero y Elvira Pol. Ind. Postuero - Nave 7-8 Full time

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

  • Pharmacy Audit Support Representative

    3 weeks ago

    Cebu City, Central Visayas, Philippines Comercial Navero y Elvira Pol. Ind. Postuero - Nave 7-8 Full time

    Join to apply for the Pharmacy Audit Support Representative role at Comercial Navero y Elvira Pol. Ind. Postuero - Nave 7-8About The RoleWe 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...

  • Pharmacy Claims Coordinator

    3 weeks ago

    Cebu City, Central Visayas, Philippines Comercial Navero y Elvira Pol. Ind. Postuero - Nave 7-8 Full time

    OverviewWe\'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 DoConduct desk and on-site pharmacy audits.Review claims for errors, discrepancies, or fraud.Communicate with pharmacies to resolve billing issues.Prepare...

  • Pharmacy Claims Coordinator

    7 days ago

    Cebu City, Philippines Comercial Navero y Elvira Pol. Ind. Postuero - Nave 7-8 Full time

    Overview 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....

  • Pharmacy Support Professional

    2 weeks ago

    Makati City, National Capital Region, Philippines beBeePharmacy Full time ₱600,000 - ₱850,000

    Job DescriptionWe are seeking a skilled professional to fill the role of Pharmacy Assistant. The successful candidate will be responsible for supporting day-to-day pharmacy operations in our outpatient clinic.Key Responsibilities:To assist in dispensing prescribed medications accurately and efficiently.Provide guidance to patients on proper medication use,...

  • Virtual Pharmacy Support Specialist

    2 weeks ago

    Davao City, Davao, Philippines beBeePharmacist Full time $45,000 - $70,000

    We are seeking a highly skilled Virtual Pharmacist Assistant to join our team. In this role, you will provide administrative support to our pharmacist and healthcare team by managing medication records, coordinating patient communications, processing prescriptions, and ensuring compliance with healthcare protocols.Key Responsibilities:Patient...

  • Pharmacy Assistant

    2 weeks ago

    Quezon City, National Capital Region, Philippines METRO NORTH MEDICAL CENTER AND HOSPITAL, INC. Full time ₱104,000 - ₱130,878 per year

    Assists pharmacists in preparing and dispensing of medicines requested by different department and Out Patient/s.Responsible in rendering all requests from different departments and nursing stations with the supervision of the chief pharmacist/pharmacists.Maintain and organize inventory of e-cart and floor stocks in different department and nursing...

  • Medical Representative

    7 days ago

    Cebu City, Philippines Mc1 - Alpha Alpha Health Screen Laboratory Full time

    Overview The Medical Representative is responsible for promoting and selling medical products or services to healthcare professionals, building relationships, and achieving sales targets. Responsibilities Promote and present medical products to doctors, hospitals, and pharmacies. Build and maintain strong relationships with healthcare professionals. Provide...

  • pharmacy assistant

    2 weeks ago

    Quezon City, National Capital Region, Philippines 5G-RLMY PHARMALAND INC. Full time $104,000 - $130,878 per year

    About usWe are the Franchisee of Generika Drugstore who operates 25 branches in Quezon City, Laguna Area, North and South Caloocan and still growing.Our MISSION is to innovate services, support growth, and positively influence our business partners and other entrepreneurs to embrace the Generika Drugstore business, achieve business management expertise and...

  • Pharmacy Assistant

    1 week ago

    Mandaluyong City, National Capital Region, Philippines Makati Hope Christian School - Ortigas Full time ₱150,000 - ₱250,000 per year

    The Pharmacy Assistant is responsible for the daily handling of transactions and interaction with customers, selling over-the-counter medicines.Takes in and hands out prescriptions.Attends to sales transactions following established procedures.Familiarizes self with products and educates self more about health and wellness.Prepares orders of merchandise and...

  • Medical Sales Representative

    7 days ago

    Cebu City, Philippines Vintel Med Enterprises Full time

    About Vintel Med Enterprises Vintel Med Enterprises (VME) is a pharmaceutical company that has over 19 years of experience distributing quality medicines to patients, enhancing the quality of life of people through access to the best medicines and technology at affordable cost. Key Responsibilities VME is currently looking for a Medical Sales...