Pharmacy Audits Clerk-Department Specialist III

Job Overview:

To assist the Assistant Manager of Third Party Audits and complete a variety of specialized duties that supports compliance and audits. The duties focus on tasks and/work that are unique to the department and require knowledge and skills that are beyond what are required for general office work.

Job Responsibilities and Accountabilities:

• Manage and prioritize the incoming audit notifications from PBMs, CMS, and other auditing entities.
• Develop communication documents for stores to ensure timely and accurate retrieval of desktop/onsite documentation.
• Manage the retrieval of documents, certify for accuracy and compliance and submit documentation for desktop audits in a timely manner.
• Communicate the summarization of audit results for onsite and desktop audits.
• Manage the process to coordinate, maintain and notify stores, Field Evaluators, DPM's and TPM's of upcoming onsite audits.
• Manage the retrieval of documents, certify for accuracy and compliance and prepare them for rebuttal for desktop audits.
• Responsible for data entry of all audit request via PATS (Prescription Audit Tracking Software).
• Identify opportunities to improve PATS processes to maximum results and efficiencies.
• Identify repeat audit issues from desktop and on site audit results .
• Work with Assistant Manager of Third Party Audits to develop a plan to mitigate further risk from desktop and on site results.
• Work with Assistant Manager of Third Party Audits to identify and develop enhancements to the PATS database and all tasks performed in the audit department for maximum efficiencies.
• Utilize data sources such as RxView, Impromptu, Central Reporting, PATS and other Third Party Billing tools to react and respond to audit requests.
• Manage audit department filing system.

Job Requirements:

Relevant Experience, Education, Certification, Knowledge, Skills and Abilities:

• Retail Pharmacy experience- 2 year minimum required.
• Previous experience as Help Desk Coordinator preferred but not required.
• Pharmacy Technician License required.
• Intermediate PC knowledge of Excel, Access, PowerPoint and company email.
• Pharmacy Operational experience- 2 years.
• Knowledge of the organizational operations of the pharmacy business- 2 years.
• Ability to negotiate.
• Effective communication skills both written and verbal.
• Good computer skills: word processing and/or spreadsheet.
• Strong problem solving / prioritizing skills.
• Ability to multi-task and Strong organizational skills.

The above statements are intended to describe the general nature of the work performed by the employees assigned to this job. All employees must comply with Company policy and applicable laws. The responsibilities, duties and skills required of personnel so classified may vary within each department and/or location.