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Pharmacy Tech Audit Analyst - Irvine, CA

UnitedHealth Group


Location:
Irvine, CA
Date:
08/18/2017
2017-08-182017-09-16
Job Code:
1773985
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Job Details


Pharmacy Tech Audit Analyst - Irvine, CA(Job Number:725530)
Description

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)

 
Located in our Irvine, California office, the Pharmacy 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

Job Pharmacy Audit
Primary Location US-CA-Irvine
Other Location 
Organization OptumRx Audit & Regulatory
Schedule Full-time
Number of Openings 1
Apply on the Company Site

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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