Senior Pharmacy Audit Representative

UnitedHealth Group • US, California, CA

4d • $20 - $36 • Remote

About The Position

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

Requirements

• High School Diploma/GED (or higher)
• Active and unrestricted Pharmacy Technician License in state of residence
• Active and unrestricted National Pharmacy Technician Certification (ExCPT or PTCB)
• 2+ years of experience as a Pharmacy Technician in a retail pharmacy, PBM or specialized pharmacy
• 2+ years of experience in Microsoft Word (creating/updating documents) and Microsoft Excel (creating/updating spreadsheets, pivot tables, and formulas)
• Flexibility to work as late as 5:00 PM Pacific Time
• Reside in the United States in the Central, Mountain, Pacific or Eastern Time Zone

Responsibilities

• Review and analyze pharmacy claims data, applying knowledge of pharmacy policy and practice and data mining techniques to determine details of potential wasteful, erroneous, or abusive billing activity using the Real Time Application System and various reports
• Outreach to pharmacies, mostly telephonically, to verify pharmacy billing and have pharmacies correct claims if applicable
• Use in-depth knowledge of pharmacy operations, drug calculations, and pharmaceutical drug resources to evaluate if pharmacy claims are billed correctly
• Achieve assigned client goals and expectations
• Collaborate with fellow auditors to complete assigned work and recovery targets

Benefits

• Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
• Medical Plan options along with participation in a Health Spending Account or a Health Saving account
• Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
• 401(k) Savings Plan, Employee Stock Purchase Plan
• Education Reimbursement
• Employee Discounts
• Employee Assistance Program
• Employee Referral Bonus Program
• Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: High school or GED