Identifying and evaluating potential waste and compliance issues, the full-time remote Pharmacy Claims Auditor will conduct in-depth analyses of pharmacy claims, educate network pharmacies on compliance standards, and support audit-related projects. Key responsibilities Conduct in-depth analysis of large datasets and audit findings to detect high-risk pharmacy claims and billing irregularities Research and select appropriate audit samples, prioritizing pharmacy claims based on risk indicators and compliance concerns Evaluate pharmacy claims and supporting documentation to ensure alignment with contractual terms and applicable regulations Required qualifications Bachelor's degree in Health Science or related area, or equivalent combination of education and experience; high school diploma or GED required 2 years of work experience in pharmacy settings or Pharmacy Benefit Management, including 1 year in operations, audit, or quality assurance National Pharmacy Technician Certification through PTCB or ExCPT (CPhT) Must be eligible to work in the United States without the need for work visa or residency sponsorship