Pharmacy Claims Protection Specialist

1 day ago


Cebu City, Central Visayas, Philippines beBeeClaimsAuditor Full time ₱250,000 - ₱450,000
Job Overview

We are seeking a skilled professional to safeguard our claims data and prevent fraud.

Responsibilities
  • Conduct audits of pharmacy claims to identify errors, discrepancies or fraudulent activity.
  • Analyze billing activities to ensure compliance with regulations.
  • Communicate with pharmacies to resolve billing issues and address any concerns.
  • Prepare detailed reports of audit findings and recommend corrective actions.
  • Ensure accurate documentation of results and client invoicing.
Requirements
  • Bachelor's degree in Pharmacy or related field + 1 year experience in pharmacy claims auditing (Long Term Care, Specialty or Mail Order a plus).
  • Pharmacy Technician license required; national certification preferred.
  • Strong knowledge of pharmacy laws and regulations.
  • Proficient in MS Office; SQL/SAS knowledge an asset.
  • Excellent analytical, problem-solving and communication skills.
Seniority Level
  • N/A
Employment Type
  • Full-time
Job Function
  • Finance and Sales
Industries
  • Individual and Family Services


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