Third Party Audit Senior Coordinator

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary/Job Description:

The Third Party Audit Senior Coordinator will be responsible for the timely, accurate, and compliant management of third party retail pharmacy audits. This role will facilitate the audit process coordinating between payers and the retail pharmacy staff to resolve and complete audit documentation requests and inquiries. Their daily tasks will include proactively reviewing requested claim documentation for completeness, responding to audits within the allotted timeframe, and evaluating audit discrepancies for refutation opportunities to mitigate the bad debt associated.

Required Qualifications:

• 2+ years professional experience, preferably in a retail pharmacy or pharmacy call center setting
• 2+ years using Excel and Outlook in a professional or academic setting
• Ability to complete work based on productivity standards (SLA) with minimal supervision
• Ability to interact professionally with business partners (internally and externally)
• Ability to work individually or with a team to identify and define problems, evaluate alternatives, and implement practical, cost-effective solutions

Preferred Qualifications:

• 1+ year experience with RxConnect System
• Desire to seek continued professional growth
• Prefer candidates living in the Eastern time zone

Education

Verifiable High School diploma or GED is required

Anticipated Weekly Hours

Time Type

Pay Range

The typical pay range for this role is:

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.  The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.  This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. 
 

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.

• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

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Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.