Pharmacy Claims Auditor, CPhT

Jobtailor; San Antonio (TX); On-site; USD 52,000 - 72,000; Full time

Job summary

Jobtailor is seeking a Pharmacy Auditor in San Antonio, TX to examine pharmacy records, ensure compliance with regulations, and support clients with audit results. The role requires strong pharmacy knowledge, auditing skills, and the ability to travel for site visits.

Responsibilities include reviewing documentation, researching regulatory requirements, and communicating audit findings to clients. This position emphasizes accuracy, professionalism, and adherence to standards across multiple

Qualifications

• Certification as National CPhT or ability to obtain within first months.
• Extensive retail pharmacy experience.
• Resident within commutable distance to San Antonio, TX.
• Valid driver’s license and reliable car for local visits.
• Willingness to travel overnight up to 25%.
• Proficiency with Windows and Microsoft Office.
• Ability to stand for up to 8 hours and lift 20 lb.

Responsibilities

• Examine and interpret pharmacy records against submitted claim data for discrepancies.
• Apply client instructions and regulations when accessing pharmacy documentation.
• Research board of pharmacy regulations and related laws.
• Respond to audit results and report to clients regularly.
• Conduct onsite, desktop, and credentialing audits.
• Review documentation against claim data using prescription knowledge.
• Assess and describe pharmacy operations and procedures.
• Make confirmation calls to pharmacies before audit dates and reschedule as needed.
• Perform other assigned duties.

Skills

Retail Pharmacy Experience

Pharmacy Auditing

Windows Proficiency

Microsoft Office Proficiency

Education

National CPhT Certification

Tools

Windows

Microsoft Office

Job description

• Examine and interpret pharmacy records against submitted claim data for discrepancies


• Apply client instructions, federal and state regulations, and standards of practice when accessing pharmacy documentation


• Research board of pharmacy regulations and state/federal laws related to prescription requirements and pharmacy practices


• Respond to pharmacy calls regarding audit results and periodically report results to clients


• Conduct onsite, desktop, and credentialing audits professionally and respectfully


• Review pharmacy-submitted documentation against claim data using prescription knowledge


• Assess and produce detailed descriptions of pharmacy operations and procedures


• Make confirmation calls to pharmacies before audit dates and handle audit reschedules


• Perform other assigned duties and responsibilities

Requirements

• National CPhT Certification through the Pharmacy Technician Certification Board (PTCB), or ability to obtain it within the first few months


• Extensive retail pharmacy experience


• Living within commutable distance to the assigned territory in San Antonio, Texas


• Valid driver's license and reliable car for visiting pharmacies in the local geography


• Ability to travel overnight/by flight one week per month (25%)


• Proficiency with Windows and Microsoft Office


• Ability to stand for long periods, up to 8 hours


• Ability to lift heavy boxes of prescription records, approximately 20 lbs.

Core Competencies

Demonstrates expertise in pharmacy operations, compliance with federal and state regulations, and proficiency in auditing processes. Capable of effectively communicating audit results and managing pharmacy relationships.

Highest-signal resume keywords

• National CPhT Certification


• Retail Pharmacy Experience


• Pharmacy Auditing


• Windows Proficiency


• Microsoft Office Proficiency

Hard Skills

• Pharmacy Record Examination


• Claim Data Interpretation


• Regulatory Research


• Audit Reporting


• Prescription Knowledge

Soft Skills

• Professional Communication


• Respectful Interaction

Certifications & Qualifications

• National CPhT Certification

Industry Keywords

• Pharmacy Regulations


• State/Federal Laws


• Pharmacy Practices


• Audit Procedures


• Credentialing Audits

Tools & Technologies

• Windows


• Microsoft Office