Pharmacy Claims Audit Analyst

April 3

🧀 Wisconsin – Remote

Although this job is listed in Wisconsin, this company may be open to hiring remote in other states.

💵 $50k - $75k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Analyst

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Brown & Brown Insurance

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Brown & Brown Insurance is one of the largest independent insurance brokerages globally, providing innovative insurance solutions and risk management services to protect the personal and business assets of its clients. Established in 1939 and publicly traded since 1993, Brown & Brown has grown through a disciplined strategy of acquiring culturally and financially suitable companies. With a strong emphasis on diversity, inclusion, and belonging, the company fosters a unique culture that rewards self-starters and focuses on delivering exceptional service through its 500+ locations worldwide.

Property & Casualty Insurance • Employee Benefits • Personal Lines

10,000+ employees

Founded 1939

🏢 Enterprise

📋 Description

• Complete pharmacy claims audits to ensure compliance to PBM contracts. • Facilitate calls with PBMs, obtain claims audit data, perform data quality checks. • Develop, prioritize, and conduct financial audits to evaluate PBM contracts, controls, and accuracy of financial information. • Comply with and adhere to all regulatory compliance areas, policies, and procedures (including HIPAA requirements), and "leading practices". • Draft audit reports to effectively communicate the results of analysis to Remedy account team.

🎯 Requirements

• Bachelor’s degree in Business or Healthcare related field and/or similar discipline with analytical bias • Pharmacy claims audit experience &/or knowledge of pharmacy claims data • Experience working with Pharmacy and/or Medical claims data • Relevant experience that demonstrates problem-solving, financial acumen, and analytical output • Proficiency in MS Office applications (Excel, Word, Powerpoint, etc.) • Ability to thrive in a fast-paced environment, responding quickly to oversight and following instruction closely, while anticipating needs and developing efficiencies on repeat tasks • Excellent verbal and written communication skills to assemble data as applicable • Experience developing and maintaining effective, collaborative working relationships with clients and internal stakeholders • Strong sense of project ownership and the ability to manage high project volume effectively • Excellent problem-solving, critical thinking and analytics skills with the ability to work in a cross-functional team • Must be able to adapt to change in direction and priorities in a project and deadline-oriented environment.

🏖️ Benefits

• Health Benefits: Medical/Rx, Dental, Vision, Life Insurance, Disability Insurance • Financial Benefits: ESPP; 401k; Student Loan Assistance; Tuition Reimbursement • Mental Health & Wellness: Free Mental Health & Enhanced Advocacy Services • Beyond Benefits: Paid Time Off, Holidays, Preferred Partner Discounts and more.