Pharmacy Audit And Reconciliation Specialist

Ohio State University

Columbus, OH, US
Onsite
Reconciling payer remittances
Understanding claim exceptions
Resolving payment discrepancies
This role optimizes the payment cycle for retail and specialty pharmacy claims by ensuring accurate workflow of pharmacy accounts

Job Summary

  • This role optimizes the payment cycle for retail and specialty pharmacy claims by ensuring accurate workflow of pharmacy accounts.
  • The specialist secures third-party payments, ensures compliance with payer contracts, and maintains accurate secondary billing processes.
  • Candidates must be registered technicians with the State of Ohio Board of Pharmacy and hold active PTCB/NHA certification.

Matching Summary

This role optimizes the payment cycle for retail and specialty pharmacy claims by ensuring accurate workflow of pharmacy accounts.

Skills & Requirements

Must-have

  • reconciling payer remittances
  • understanding claim exceptions
  • resolving payment discrepancies
  • defending audit requests

Nice-to-have

  • proactive communication with staff
  • identifying reimbursement trends
  • scalable process improvements

Key Requirements

  • Bachelor's in Business or Healthcare
  • 2 to 4 years relevant experience
  • Registered technician with Ohio Board of Pharmacy
  • Active PTCB or NHA certification

Work Rights

Not specified

Tailored Resume

Cover Letter