Pharmacy Auditor
Express Scripts Canada - Mississauga, ON

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Express Scripts Canada has an exciting opportunity for an experienced Retail Pharmacy Technician who is looking to take the next step in their career as an On-site Pharmacy Auditor. The successful candidate will be able to demonstrate a strong ability to multi-task priorities while maintaining professional rapport when dealing with internal and external customers. This candidate must be willing and able to travel throughout Canada.

Key Responsibilities:

  • Conduct on-site and desk audits to ensure that providers have retained the appropriate documentation in support of each claim, in accordance with Provincial and Federal Legislation and their Provider Agreement.
  • Documentation, selection and preparation of claims to be audited.
  • Communicate with providers, internal and external customers to ensure service standards are met.
  • Conduct an extensive analysis of a provider claims report using established audit procedures to identify abnormal or inconsistent claims submission practices.
  • Verify audit data through communication with the prescribing physician and/or insured client to ensure that services paid for were authorized by the prescriber and received by the insured.
  • Assimilate audit data and generate the audit report that is sent to the provider within a set time frame and receive the audit recovery and produce a Carrier recovery report. File all audit related data and documentation on the server.

Qualifications:

  • A minimum of three years recent retail pharmacy experience including; COB (Coordination of Benefits) and DUR (Drug Utilization Review) knowledge.
  • Graduate of an accredited Pharmacy Assistant Program
  • Proficient in computer applications (Word, Excel, Outlook) familiarity with Pharmacy software systems
  • Proven time and resource management skills to ensure deadlines are met
  • Must be detail oriented with strong organizational abilities
  • Excellent verbal and written communication
  • Demonstrated team player
  • Bilingualism (French & English) is an asset
  • Must have a valid Canadian driver’s license
  • Available to travel frequently (including remote Canadian locations) up to 50% of the time

ABOUT EXPRESS SCRIPTS CANADA

Express Scripts Canada, a registered business name of ESI Canada, an Ontario partnership indirectly controlled by Express Scripts, Inc. (Nasdaq: ESRX), is one of Canada’s leading providers of health benefits management services. From its corporate headquarters in Mississauga, Ontario, just outside Toronto, Express Scripts Canada provides a full range of integrated pharmacy benefit management (PBM) services to insurers, third-party administrators, plan sponsors and the public sector, including health-claims adjudication and processing services, Home Delivery Pharmacy Services, benefit-design consultation, drug-utilization review, formulary management, and medical and drug-data analysis services, to better facilitate the best possible health outcomes at the lowest possible cost.

It will be a condition of employment that the successful candidate receives the Enhanced Reliability Clearance from the Federal Government. The candidate will be required to provide supporting documentation in order to receive Clearance if required.

We offer a competitive salary and benefits package, along with a positive work environment built on solid corporate values, integrity, mutual respect, collaboration, passion, service and alignment.

We are an equal opportunity employer that promotes a diverse, inclusive and accessible workplace. By embracing diversity, we build a more effective organization that empowers our employees to be the best that they can be.

We are committed to creating a working environment that is barrier-free and we are prepared to provide accommodation for people with disabilities.

Thank you for your interest in this position however, only qualified candidates will be contacted for an interview. No telephone calls please.

For more information about Express Scripts Canada, visit its Web site at www.express-scripts.ca.


Indeed - 19 months ago - save job - block
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