Remote Pharmacy Auditor I – Compliance & Audits

EXL; Oregon; Híbrido; USD 45.000 - 58.000; Jornada completa

Descripción de la vacante

EXL Health, located 100% remote in the US, seeks a Pharmacy Auditor I to perform desk and onsite audits of prescription claims. The role requires a CPhT and active license, with travel up to 10% for team meetings and limited client engagements. Salary ranges from $45,000 to $58,000 annually depending on experience.

The position emphasizes accuracy, HIPAA compliance, and timely documentation across audit workflows and client requirements.

Formación

• High School Diploma or Equivalent.
• Certified Pharmacy Technician (CPhT) and active state license/registration where required.

Responsabilidades

• Conduct desk audits by reviewing prescription claims and supporting docs for compliance and discrepancies.
• Review pharmacy records including prescriptions, signature logs, proof of delivery, invoices and dispensing records.
• Apply audit procedures and criteria to determine claim support and identify recoverable findings.
• Maintain complete audit documentation and case notes in required systems and workflows.
• Perform quality review and validation to ensure findings are accurate and complete.
• Conduct onsite or virtual audits, interacting with pharmacy personnel and gathering evidence.
• Travel up to 10% annually as needed for meetings or client engagements.
• Communicate status, issues, and deadlines with Audit Coordinators and stakeholders.
• Stay updated on state/federal requirements and HIPAA/privacy guidelines.

Educación

High School Diploma or Equivalent

Descripción del empleo

EXL Health, located 100% remote in the US, seeks a Pharmacy Auditor I to perform desk and onsite audits of prescription claims. The role requires a CPhT and active license, with travel up to 10% for team meetings and limited client engagements. Salary ranges from $45,000 to $58,000 annually depending on experience.

The position emphasizes accuracy, HIPAA compliance, and timely documentation across audit workflows and client requirements.