[Hiring] Pharmacy Claims Audit Analyst @001 Brown & Brown, Inc
Apr 02, 2025 - 001 Brown & Brown, Inc is hiring a remote Pharmacy Claims Audit Analyst. đź’¸ Salary: $50,000 - $75,000 annual. đź“ŤLocation: USA.
Role Description
The Pharmacy Claims Audit Analyst will be responsible for completing pharmacy claims audits to ensure compliance to PBM contracts. This role will involve:
- Facilitating calls with PBMs
- Obtaining claims audit data
- Performing data quality checks
- Data reconciliation
- Running and analyzing Oracle output reports
- Running ad-hoc reporting
- Reviewing PBM contracts
- Completing audit support documentation
- Working with the client support team to develop PBM & client deliverables
This role will develop, prioritize, and conduct financial audits to evaluate the effectiveness of PBM contracts, controls, and accuracy of financial information.
Job Responsibilities include:
- Planning and developing the audit approach for assigned projects consistent with guidelines established by Remedy internal Audit Standards
- Working simultaneously on multiple audits with differing deadlines while maintaining attention to detail within the appropriate timelines
- Tracking open audit observations and performing follow-up to evaluate the adequacy of remediation efforts with both PBM and Remedy account team
- Working with Lead auditor to continuously improve upon current audit automation transforms based on audit findings, industry changes, and technology updates
- Drafting audit reports to effectively communicate the results of the analysis to Remedy account team
- Complying with and adhering to all regulatory compliance areas, policies, and procedures (including HIPAA requirements), and "leading practices"
- Performing (daily/weekly) ad hoc data reporting requests as prioritized per Department Management
Qualifications
- Bachelor’s degree in Business or Healthcare related field and/or similar discipline with analytical bias
- Pharmacy claims audit experience &/or knowledge of pharmacy claims data
- Experience working with Pharmacy and/or Medical claims data
- Relevant experience that demonstrates problem-solving, financial acumen, and analytical output
- Proficiency in MS Office applications (Excel, Word, Powerpoint, etc.)
- Ability to thrive in a fast-paced environment, responding quickly to oversight and following instruction closely, while anticipating needs and developing efficiencies on repeat tasks
- Excellent verbal and written communication skills to assemble data as applicable
- Experience developing and maintaining effective, collaborative working relationships with clients and internal stakeholders
- Strong sense of project ownership and the ability to manage high project volume effectively
- Excellent problem-solving, critical thinking and analytics skills with the ability to work in a cross-functional team
- Must be able to adapt to change in direction and priorities in a project and deadline-oriented environment
Requirements
- Experience in Project Management (preferred but not required)
- Familiarity with low code to no code solutions
- Experience working with data and reporting
Benefits
- Health Benefits: Medical/Rx, Dental, Vision, Life Insurance, Disability Insurance
- Financial Benefits: ESPP; 401k; Student Loan Assistance; Tuition Reimbursement
- Mental Health & Wellness: Free Mental Health & Enhanced Advocacy Services
- Beyond Benefits: Paid Time Off, Holidays, Preferred Partner Discounts and more
Pay Range
50000 - 75000 Annual. The pay range provided above is made in good faith and based on our lowest and highest annual salary or hourly rate paid for the role and takes into account years of experience required, geography, and/or budget for the role.
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| đź“Ť | Be aware of the location restriction for this remote position: USA |
| ‼ | Beware of scams! When applying for jobs, you should NEVER have to pay anything. Learn more. |
|
Salary
đź’¸
$50,000 - $75,000 annual
|
Remote
Location
USA
|
|
Job Type
full-time
|
Posted
Apr 02, 2025
|
| đź“Ť | Be aware of the location restriction for this remote position: USA |
| ‼ | Beware of scams! When applying for jobs, you should NEVER have to pay anything. Learn more. |
