The CSI Companies is a national staffing and recruiting firm established in 1994 specializing in temporary placement, contract-to-hire, and direct-hire placements across the United States. Currently, we are seeking to hire a Pharmacy Audit/Billing Specialist for one of our top clients in Altamonte Springs, FL!
This is a direct-hire opportunity with great benefits!
Hours: M-F Standard Business Hours
The position will encompass working Medicare, Medicaid, Pharmacy and Major Medical Audits. This position will also assist with watermarking duties, billing duties and assist with audit appeals as directed by Management. This position requires strict compliance with all HIPAA and FWA standards and privacy standards.
SCOPE OF ROLE AND RESPONSIBILITIES:
To work with the Audit Manager to compile information for PBM, Medicare, Medicaid and paper claims Audit requests. Perform internal auditing of claims for various teams. Assisting the billing team as needed. Perform water marking and other special projects as assigned.
- Gather information as appropriate per the audit request.
- Research for documentation needed to complete the audits.
- Ensure all audits are reviewed by Pharmacist/Manager or other manager as directed prior to submission.
- Track audits in an organized, searchable and reportable method.
- Results of audits will be analyzed and submitted to the audit team for discussion of issues and suggested improvements.
- Audit claims for various teams to ensure claims are submitted correctly.
- Track and distribute results to appropriate Management staff.
- Assist billing team as requested.
- Watermarking as per the direction of Manager/Pharmacist.
QUALIFICATIONS & ABILITIES:
- Detail oriented
- Ability to write effectively
- Ability to research and effectively communicate findings.
- Reimbursement Background preferred
- Collections and cash posting knowledge preferred
- Experience with and detailed knowledge of Medicare Practices preferred
- Experience with and detailed knowledge of Commercial / Pharmacy Practices preferred
REQUIRED EDUCATION/TRAINING AND/OR PROFESSIONAL EXPERIENCE:
- High School Diploma or equivalency
- Reports to the Audit Manager
For more information/how to apply: please attach a copy of your most polished, detailed updated resume today!