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Pharmacy Technician Audit Analyst - Irvine CA

Company name

Irvine, CA

Date Last Verified
Mar 14,2018

Posted on
Mar 13,2018

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For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm)

The Pharmacy Technician Audit Analyst will analyze and monitor claims against fraud, waste, and abuse related to retail pharmacy and long - term care networks.

Primary Responsibilities:

Amends audit reports and determines overpayments

Collaborates with Claims Administration in the reverse and re - billing of overpaid claims

Analyze and monitor claims data received from contracted entity related to retail pharmacy and long - term care networks

Coordination of timely closure of audits

Reviews and analyzes claims data, applying knowledge of pharmacy policy / practice and data mining techniques to determine details of overpayment billing activity while assisting with oversight of contracted program

Monitors and reports accordingly any compliance issues with regulatory requirement

Identifies and documents fraudulent or erroneous activities determined as a result of an on - site audit

Assists in the PARC appeal process

Required Qualifications:

High School Diploma or equivalent

3 years of experience as a Pharmacy Technician

Current and unrestricted Pharmacy Technician license in the state of residence

Strong written communication skills

Proficient computer skills including Microsoft Outlook, Word, and Excel

Preferred Qualifications:

Bachelors Degree

National Pharmacy Technician Certification

3 years of Pharmacy Audit experience

Rx Claims or other pharmacy claims system experience

Retail Pharmacy experience

Long Term Care Pharmacy experience

Specialty Pharmacy experience

5 or more years of experience as a Pharmacy Technician

Intermediate level Excel and Access skills a plus

Careers with OptumRx. Were one of the largest and most innovative pharmacy benefits managers in the US, serving more than 12 million people nationwide. Here youll fill far more than prescriptions. As a member of one of our pharmacy teams, youre empowered to be your best and do whatever it takes to help each customer. Youll find unrivaled support and training as well as a wealth of growth and development opportunities driven by your performance and limited only by your imagination. Join us. Theres no better place to help people live healthier lives while doing your lifes best work.(sm)

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment

Job Keywords: Pharm Tech, Pharmacy Technician, Licensed, National Certification, Audit, Auditing, Analyst, Analyze, PBM, Pharmacy Benefit Management, Healthcare, Pharmacy, Investigate, Investigation, UHG, UnitedHealth Group, Optum, OptumRx, Irvine, CA, California

Company info

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Company Profile
We collaborate with partners across the system to lead change in health care. Together, we are transforming health care for a better future for everyone we serve. Our partners choose us for our combination of unique capabilities.

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