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Pharmacy Claims Auditor, CPhT

Job in San Antonio, Bexar County, Texas, 78208, USA
Listing for: Jobtailor
Full Time position
Listed on 2026-09-25
Job specializations:
  • Healthcare
    Pharmacy Technician, Pharmacy
Salary/Wage Range or Industry Benchmark: 52000 - 72000 USD Yearly USD 52000.00 72000.00 YEAR
Job Description & How to Apply Below
  • Examine and interpret pharmacy records against submitted claim data for discrepancies
  • Apply client instructions, federal and state regulations, and standards of practice when accessing pharmacy documentation
  • Research board of pharmacy regulations and state/federal laws related to prescription requirements and pharmacy practices
  • Respond to pharmacy calls regarding audit results and periodically report results to clients
  • Conduct onsite, desktop, and credentialing audits professionally and respectfully
  • Review pharmacy-submitted documentation against claim data using prescription knowledge
  • Assess and produce detailed descriptions of pharmacy operations and procedures
  • Make confirmation calls to pharmacies before audit dates and handle audit reschedules
  • Perform other assigned duties and responsibilities
Requirements
  • National CPhT Certification through the Pharmacy Technician Certification Board (PTCB), or ability to obtain it within the first few months
  • Extensive retail pharmacy experience
  • Living within commutable distance to the assigned territory in San Antonio, Texas
  • Valid driver's license and reliable car for visiting pharmacies in the local geography
  • Ability to travel overnight/by flight one week per month (25%)
  • Proficiency with Windows and Microsoft Office
  • Ability to stand for long periods, up to 8 hours
  • Ability to lift heavy boxes of prescription records, approximately 20 lbs.
Core Competencies

Demonstrates expertise in pharmacy operations, compliance with federal and state regulations, and proficiency in auditing processes. Capable of effectively communicating audit results and managing pharmacy relationships.

Highest-signal resume keywords
  • National CPhT Certification
  • Retail Pharmacy Experience
  • Pharmacy Auditing
  • Windows Proficiency
  • Microsoft Office Proficiency
Hard Skills
  • Pharmacy Record Examination
  • Claim Data Interpretation
  • Regulatory Research
  • Audit Reporting
  • Prescription Knowledge
Soft Skills
  • Professional Communication
  • Respectful Interaction
Certifications & Qualifications
  • National CPhT Certification
Industry Keywords
  • Pharmacy Regulations
  • State/Federal Laws
  • Pharmacy Practices
  • Audit Procedures
  • Credentialing Audits
Tools & Technologies
  • Windows
  • Microsoft Office
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