Pharmacy Claims & Compliance Auditor

MedImpact Healthcare Systems, Inc.; United States; Remote; USD 35,000 - 57,000; Full time

Benefits offered by this job

Medical / Dental / Vision / Wellness

Paid Time Off / Holidays

Incentive Compensation

401K with Company match

Life and Disability Insurance

Tuition Reimbursement

Employee Referral Bonus

Job summary

MedImpact Healthcare Systems, Inc. is seeking a Compliance Auditor to perform desk and onsite audits of retail, mail order, specialty, and LTC pharmacies. You will verify credentials, ensure regulatory compliance, and document findings to support audit outcomes.

You will develop audit plans, analyze claims data, communicate results to pharmacies, and help ensure timely invoicing. The role requires attention to detail and strong knowledge of federal and state regulations.

Qualifications

• BS/BA and 2+ years’ experience or equivalent combination of education and experience.
• Pharmacy Technician license or national certification (PTCB).
• Experience with MS Office; SQL; MedAccess/MedOptimize preferred.
• Knowledge of federal/state pharmacy regulations and audit processes.

Responsibilities

• Pre-Pay reviews, desk and onsite audits to evaluate regulatory compliance.
• Analyze claim data and dispensing practices for discrepancies.
• Prepare audit requests and documentation for verification.
• Develop audit plans, schedules, and travel arrangements as needed.
• Publish audit outcome reports and communicate results to pharmacies.

Skills

Analytical thinking

Attention to detail

Communication skills

Problem solving

Customer focus

Education

BS/BA

Tools

MS Office

MedAccess

MedOptimize

SQL

Job description

MedImpact Healthcare Systems, Inc. is seeking a Compliance Auditor to perform desk and onsite audits of retail, mail order, specialty, and LTC pharmacies. You will verify credentials, ensure regulatory compliance, and document findings to support audit outcomes.

You will develop audit plans, analyze claims data, communicate results to pharmacies, and help ensure timely invoicing. The role requires attention to detail and strong knowledge of federal and state regulations.