Pharmacy Claims Coordinator

3 weeks ago


Cebu City, Central Visayas, 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.
  • Prepare audit reports and recommend corrective actions.
  • Document findings and ensure client invoicing accuracy.
What You\'ll Bring
  • Bachelor\'s degree + 1 year pharmacy experience (Long Term Care, Specialty, or Mail Order a plus).
  • Pharmacy Technician license required; national certification preferred.
  • Strong knowledge of pharmacy practice, laws, and regulations.
  • Proficient in MS Office; SQL/SAS knowledge a plus.
  • Excellent analytical, problem-solving, and communication skills.
Seniority level
  • Not Applicable
Employment type
  • Full-time
Job function
  • Finance and Sales
Industries
  • Individual and Family Services

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