PRIMARY DUTIES AND RESPONSIBILITIES

• Responsible for tracking, trending and coordinating all incoming Payer audit correspondence including but not limited to: Onsite/Desktop/Invoice audit notifications and discrepancy reports, corrective actions and recoveries;

• Provide expert audit assistance to customers including proactive audit prevention tips, pre-audit preparation guidance and support, recommend the means of obtaining, analyzing and evaluating the evidentiary data to support appeal of discrepant claims and assist with coordination of any corrective action(s) taken by a Payer;

• Conduct enhanced screening of prospect customers seeking Network affiliation using a variety of internal and external resources;

• Identify opportunities to enhance audit tracking and reporting systems; recommend and implement process improvements to increase efficiency and accuracy.

• Collab Collaborate with various internal departments to identify accounts that are considered high-risk.

• Assisting in the planning and execution of pharmacy audit buy-ups to help support our customers during audits

• Responsible for maintaining good working relationships with internal and external partners;

• Responsible for acquiring knowledge of industry audit trends and compliance requirements;

• Successfully completes special projects as assigned.

• Performs related duties as assigned.

REQUIRED EXPERIENCE

• Prior pharmacy background

• Experience with pharmacy audits

• Strong knowledge of third party billing and experience with private health plans and government programs

SKILLS, KNOWLEDGE AND ABILITY REQUIREMENTS

• Excellent organizational skills

• Excellent customer service skills

• Ability to multitask and remain flexible in a fast-paced work environment.

• Ability to communicate effectively both orally and in writing

• Exceptional interpersonal abilities

• Ability to work independently with general direction

• Strong analytical skills; attention to detail

• Strong computer skills in order to operate effectively with company systems and programs knowledge of Microsoft office, specifically Access and Excel

NICE TO HAVE

• Bachelor's degree

• Experience with pharmacy compliance

• Experience with risk mitigation

• Certified or State Licensed Pharmacy Technician

WHAT CENCORA OFFERS

• Comprehensive medical and prescription coverage with optional dental and vision

• 401k plan

• Flexible Spending Accounts

• Wellbeing resources

• Hybrid working model - 2 days in the office, 3 from home

• Be part of an organisation that helps bring your aspirations, innovations, and essential services to people and animals around the world

• Work within a supportive team that values collaboration, allowing for knowledge sharing and professional growth through teamwork.

• Gain insights into industry best practices and regulatory frameworks, enhancing expertise and knowledge in audit and compliance processes.

#LI-HYBRID

What Cencora offers

We provide compensation, benefits, and resources that enable a highly inclusive culture and support our team members’ ability to live with purpose every day. In addition to traditional offerings like medical, dental, and vision care, we also provide a comprehensive suite of benefits that focus on the physical, emotional, financial, and social aspects of wellness. This encompasses support for working families, which may include backup dependent care, adoption assistance, infertility coverage, family building support, behavioral health solutions, paid parental leave, and paid caregiver leave. To encourage your personal growth, we also offer a variety of training programs, professional development resources, and opportunities to participate in mentorship programs, employee resource groups, volunteer activities, and much more. For details, visit https://www.virtualfairhub.com/cencora

Full time

$57,900 - 85,360

• This Salary Range reflects a National Average for this job. The actual range may vary based on your locale. Ranges in Colorado/California/Washington/New York/Hawaii/Vermont/Minnesota/Massachusetts/Illinois State-specific locations may be up to 10% lower than the minimum salary range, and 12% higher than the maximum salary range.

Equal Employment Opportunity

Cencora is committed to providing equal employment opportunity without regard to race, color, religion, sex, sexual orientation, gender identity, genetic information, national origin, age, disability, veteran status or membership in any other class protected by federal, state or local law.

The company’s continued success depends on the full and effective utilization of qualified individuals. Therefore, harassment is prohibited and all matters related to recruiting, training, compensation, benefits, promotions and transfers comply with equal opportunity principles and are non-discriminatory.

Cencora is committed to providing reasonable accommodations to individuals with disabilities during the employment process which are consistent with legal requirements. If you wish to request an accommodation while seeking employment, please call 888.692.2272 or email hrsc@cencora.com. We will make accommodation determinations on a request-by-request basis. Messages and emails regarding anything other than accommodations requests will not be returned

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Affiliated Companies:

Affiliated Companies: AmerisourceBergen Services Corporation