Pharmacy Claims Auditor CPhT

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    "ExternalDescriptionStr": "<p><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\"><strong>Pharmacy Claims Auditor CPhT</strong></span></span></p><p><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\">Do you have a CPhT certification?</span></span><br><br><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\">Would you like to audit pharmacy claims for accuracy?</span></span><br><br><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\"><strong>About the Role</strong></span></span><br><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\">&nbsp;</span></span></p><p><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\">Conduent Payment Integrity Solutions performs in depth pharmacy audits on behalf of our healthcare payer clients. As a Pharmacy Claims Auditor CPhT, you will examine a wide variety of pharmacy records against our client’s pharmacy claim data. This is to ensure billed pharmacy claims are being accurately submitted. You will also be required to represent our clients and conduct \"on-site\" pharmacy audits.</span></span><br><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\">&nbsp;</span></span></p><p><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\"><strong>Responsibilities</strong></span></span><br><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\">&nbsp;</span></span></p><ul style=\"list-style-type:disc;\"><li style=\"tab-stops:list .5in;\"><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\">Examining and interpreting pharmacy records against submitted claim data for potential discrepancies.</span></span></li><li style=\"tab-stops:list .5in;\"><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\">Utilizing specific client instructions, federal and state regulations, and standards of practice to properly access pharmacy documentation.</span></span></li><li style=\"tab-stops:list .5in;\"><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\">Researching board of pharmacy regulations, and state/federal laws as they relate to prescription requirements and pharmacy practices.</span></span></li><li style=\"tab-stops:list .5in;\"><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\">Responding to pharmacy calls regarding audit results and dealing with clients periodically to report audit results.</span></span></li><li style=\"tab-stops:list .5in;\"><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\">Conducting Onsite and Desktop and Credentialing Audits in a professional and respectful manner.</span></span></li><li style=\"tab-stops:list .5in;\"><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\">Using prescription knowledge to review pharmacy submitted documentation against submitted claim data.</span></span></li><li style=\"tab-stops:list .5in;\"><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\">Assessing and producing detailed descriptions of pharmacy operations and procedures.</span></span></li><li style=\"tab-stops:list .5in;\"><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\">Making confirmation calls to pharmacies prior to audit date and personally handling audit reschedules.</span></span></li><li style=\"tab-stops:list .5in;\"><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\">Performing other duties and responsibilities as assigned</span></span></li></ul><p><br><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\"><strong>Requirements</strong></span></span><br><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\">&nbsp;</span></span></p><ul style=\"list-style-type:disc;\"><li style=\"tab-stops:list .5in;\"><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\">Have National CPhT Certification through the Pharmacy Technician Certification Board (PTCB). Or be able to obtain one within the first few months.</span></span></li><li style=\"tab-stops:list .5in;\"><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\">Have extensive “retail” pharmacy experience.</span></span></li><li style=\"tab-stops:list .5in;\"><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\">Be living in commutable distance to the assigned territory (Miami FL)</span></span></li><li style=\"tab-stops:list .5in;\"><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\">Have valid driver's license and have a reliable car to visit pharmacies for audits in the local geography.</span></span></li><li style=\"tab-stops:list .5in;\"><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\">Be able to travel&nbsp;overnight/flight 1 week/month (25%).</span></span></li><li style=\"tab-stops:list .5in;\"><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\">Be proficient with Windows and Microsoft Office.</span></span></li><li style=\"tab-stops:list .5in;\"><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\">Be able to stand for long periods of time (Up to 8 hours).</span></span></li><li style=\"tab-stops:list .5in;\"><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\">Be able to lift heavy boxes (about 20 lbs.) containing prescription records. (Most records are electronic.)</span></span></li></ul><p><br><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\"><strong>Flexible Working</strong></span></span><br><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\">&nbsp;</span></span></p><p><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\">At Conduent, we want you to be yourself. We recognize that everyone is different and that how people want to work and deliver at their best is different for everyone too.&nbsp;</span></span><br><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\">In this role, you can expect the following working conditions:</span></span><br><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\">&nbsp;</span></span></p><ul style=\"list-style-type:disc;\"><li style=\"tab-stops:list .5in;\"><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\"><strong>Hybrid work:</strong> Will be working from home 25% of the month and will be working in the field doing audits at different pharmacy locations 75% of the month.&nbsp;</span></span></li></ul><p><br><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\"><strong>Working for You</strong></span></span></p><p><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\">We offer perks and rewards designed to support you:</span></span></p><ul style=\"list-style-type:disc;\"><li style=\"tab-stops:list .5in;\"><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\"><strong>Health &amp; Welfare Benefits:&nbsp;</strong>Comprehensive plans tailored to your needs, effective from day one.</span></span></li><li style=\"tab-stops:list .5in;\"><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\"><strong>Retirement Savings:&nbsp;</strong>Robust programs to help you secure your financial future.</span></span></li><li style=\"tab-stops:list .5in;\"><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\"><strong>Employee Discounts:&nbsp;</strong>Access to a wide range of discounts on merchandise, services, travel, and more.</span></span></li><li style=\"tab-stops:list .5in;\"><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\"><strong>Career Growth Opportunities:&nbsp;</strong>Paths for advancement within a global organization.</span></span></li><li style=\"tab-stops:list .5in;\"><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\"><strong>Paid Training:&nbsp;</strong>Learn while you earn with award-winning learning platforms.</span></span></li><li style=\"tab-stops:list .5in;\"><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\"><strong>Paid Time Off:&nbsp;</strong>Competitive PTO packages to help you recharge.</span></span></li><li style=\"tab-stops:list .5in;\"><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\"><strong>Great Work Environment:&nbsp;</strong>Join an award-winning culture that values diversity and inclusion.</span></span></li></ul><p><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\"><strong>&nbsp;</strong></span></span></p><p><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\"><strong>Join Us:</strong></span></span></p><p><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\">At Conduent, we are united by a shared mission. We understand that our success is driven by the success of our associates. When you join us, you’ll find opportunities to:</span></span></p><ul style=\"list-style-type:disc;\"><li style=\"tab-stops:list .5in;\"><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\">Bring your authentic self to work every day.</span></span></li><li style=\"tab-stops:list .5in;\"><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\">Grow and thrive both personally and professionally.</span></span></li><li style=\"tab-stops:list .5in;\"><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\">Make a meaningful impact with our clients, in our communities, and for the millions of people we serve.</span></span></li></ul><p><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\">With over 50,000 associates in 24 countries, you’ll be part of a global team that’s shaping the future — for the company and for yourself.</span></span></p><p><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\">&nbsp;</span></span></p><p><span style=\"font-family:&quot;Verdana&quot;,sans-serif;\"><span style=\"font-size:9.0pt;line-height:115%;\">Pay Transparency Laws in some locations require disclosure of compensation and/or benefits-related information.&nbsp; For this position, actual salaries will vary and may be above or below the range based on various factors including but not limited to location, experience, and performance. In addition to base pay, this position, based on business need, may be eligible for a bonus or incentive. In addition, Conduent provides a variety of benefits to employees including health insurance coverage, voluntary dental and vision programs, life and disability insurance, a retirement savings plan, paid holidays, and paid time off (PTO) or vacation and/or sick time. The estimated salary range for this role is ($57,000).</span></span></p><p>&nbsp;</p>",
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