Express Scripts Associate Pharmacy Desk Auditor in St. Louis, Missouri
The Associate Pharmacy Desk Auditor is responsible to identify pharmacy audit risks using analytical skills and audit tools and develop and execute audit plans and scope of procedures determined necessary to address those risks. This position will complete investigational audits in order to correct risks identified and present findings to Sr. Audit Manager. The Associate Pharmacy Auditor must thoroughly read, interpret and fully understand the key elements of each specific contract.
- Utilize current programs and analytical procedures and existing tools, including Access, Excel, etc., while utilizing personal knowledge of medications to identify clients, members and claims representing financial risks.
- Responsibility for reprocessing claims identified that have been previously processed.
- Perform efficient and effective investigatory audits to produce results consistent with departmental policies and critical corporate goals while meeting or exceeding personal production goals.
- Performance of audits includes obtaining, analyzing, and appraising evidentiary data on which to base an informed, objective opinion on the accuracy and legitimacy of claims audited.
- Analyzes audit findings to determine validity of any identified discrepancies.
- Has full responsibility for handling/researching complex issues identified during an audit.
- Prepare formal and thorough written reports providing opinions on the findings of the audits performed, client impact, ESI risk, etc. as needed.
- Submit findings to Sr. Auditors and Sr. Audit Manager for review.
- Responsibility for providing ad hoc reports to key business owners.
- Special projects as assigned and as needed.
- Bachelor’s degree in related field or 6 to 8 years of experience.
- 0-2 years relevant experience with Bachelor’s Degree.
- Certified Pharmacy Technician preferred.
- Highly proficient in data warehousing, database and spreadsheet applications.
- Proficiency in CuraScript proprietary systems preferred.
- Excellent organizational and interpersonal skills.
- Excellent verbal and written communication skills.
- Excellent interpersonal skills and the ability to effectively communicate with all levels of management.
- Ability to work cross functional departments to research and resolve issues using innovative solutions.
- Demonstrated ability to meet multiple deadlines and manage a dynamic workload.
- Ability to work a flexible schedule to accommodate project deadlines.
- Ability to present audit findings and recommendations to business owners.
- Demonstrated analytical and problem solving skills.
- Ability to use judgment in analysis of findings and ability to outline recommendations for specific outcomes.
- Ability to handle sensitive or confidential information is critical to success of the role.
ABOUT THE DEPARTMENT
CuraScript SD provides integrated delivery solutions for the safe and efficient distribution of specialty pharmaceuticals and associated medical supplies. With an expertise honed by more than 25 years in the Specialty Distribution business, CuraScript SD supplies biologics, branded drugs, generics, vaccines, infused medications and ancillary supportive care products for office or clinic administration to a wide range of medical providers – including physicians, infusion centers, acute care treatment centers and long-term care facilities.
ABOUT EXPRESS SCRIPTS
At Express Scripts, we dare to imagine a better health care system, and we’re driven to make it happen. Where some see obstacles, we see possibilities. We’re challengers, difference-makers and opportunity-seekers, united with our partners in pursuit of a simpler, more sustainable system and better health for all.
We have always acted first to take on the toughest challenges. We uniquely partner across the health care ecosystem to uncover opportunities, take action, advance health care and deliver better outcomes – like no one else can. We believe health care can do more. We are Champions For BetterSM.
Express Scripts, part of Cigna Corporation, unlocks new value in pharmacy, medical and beyond to further total health for all.