Remote 340B Claims Auditor & Compliance Specialist

RXinsider LTD.; Northern (KY); Hybrid; USD 37,000 - 41,000; Full time

Benefits offered by this job

Medical deductible

Vision benefits

Dental benefits

401k plan with company match

Earned Wage Access

Paid time off

Job summary

VytlOne is seeking a 340B Pharmacy Claims Reviewer to perform scheduled reviews of prescription claims and supporting documentation to verify 340B eligibility and prevent duplicate discounts. You will collaborate with the 340B Account Specialist and stakeholders to strengthen compliance and savings.

Responsibilities include audits, resolving reconciliation issues, Medicaid claim reviews, and documenting findings. Remote work is available with a competitive benefits package.

Qualifications

• Associate degree in pharmacy technology, healthcare administration, business, or related field preferred.
• Two years of experience in pharmacy operations, healthcare auditing, or 340B program support is required.
• Strong knowledge of 340B program requirements and audit documentation.
• Ability to review claims, medical records, and insurance information accurately.

Responsibilities

• Perform scheduled audits of prescription claims and supporting documentation.
• Research and resolve reconciliation exceptions and identify process improvements.
• Review Medicaid claims to prevent potential duplicate discounts.
• Evaluate 340B eligibility by reviewing patient records and encounter status.
• Document audit results and follow-up actions in designated systems.

Skills

Analytical skills

Reconciliation

Problem-solving

Attention to detail

Education

Associate degree in pharmacy technology or related

Tools

Microsoft Office

340B systems

Pharmacy claims software

Job description

VytlOne is seeking a 340B Pharmacy Claims Reviewer to perform scheduled reviews of prescription claims and supporting documentation to verify 340B eligibility and prevent duplicate discounts. You will collaborate with the 340B Account Specialist and stakeholders to strengthen compliance and savings.

Responsibilities include audits, resolving reconciliation issues, Medicaid claim reviews, and documenting findings. Remote work is available with a competitive benefits package.