Audit Analyst- Pharmacy Technician

Job Description:Affiliated Computer Services, Inc. (ACS) is expertise in action?. We are a FORTUNE 500 company with 63,000 employees worldwide supporting client operations reaching more than 100 countries. We provide business process outsourcing and information technology solutions to world-class commercial and government clients. Our employees operate with integrity, and are flexible, reliable and responsive. If you meet the requirements of this position and want to work for a world-class company with a great marketplace reputation, apply today.ACS is an Equal Opportunity Employer and does not Discriminate against any applicant on the basis of race, color, religion/creed, national origin, gender, or sex, marital status, age, disability, use of a guide dog or service animal, sexual orientation, military/veteran status, or any other status protected by Federal or State law or local ordinance. People with disabilities who need a reasonable accommodation to apply or compete for employment with ACS may request such accommodations by calling or by sending an e-mail to accommodations@acs-.I. Pharmacy Auditor Summary: Conduct pharmacy compliance audits, Home Infusion Therapy audits, investigations, PBM audits and other pharmacy-related audits. II. Primary Job Responsibilities: Field audits Perform field audits in pharmacies and at other provider sites by traveling to provider-sites and examining source documents such as prescriptions and patient medical records. Validate and document all audit findings. Conduct audits in accordance with audit guidelines. Be able to identify fraud and abuse, and document it. Interview providers and witnesses regarding potential fraud schemes, and document such interviews. Back up all findings with applicable citations in federal, state and plan rules & regulations. Audit support activities in the Richmond, VA office Prepare for audits, making sure that the appropriate data samples are drawn, work papers are ready and pharmacies are notified. Conduct In-house audit tasks. Conduct Desk-Audits of provider data to target inappropriate therapy, questionable billing practices and aberrant behavior. Perform post-audit activities such as discrepancy validation and other follow up. Generate final reports for the client. Audit Follow-Up in the Richmond, VA office Edit, validate and report audit findings. Provide back-up documentation during negotiation proceedings. Participate in administrative hearings and court proceedings when necessary. Other analyses in the Richmond, VA office Conduct other audit and data analyses as required. Review data and claim information to support account management. Education and Typical Years ExperienceIII. Education and Experience: Education / Licensure: Current licensure as a registered Pharmacy technician. Experience / Background: A minimum of three to five years experience in retail or specialty pharmacy. No record of felony convictions or any record of Medicaid or Board of Pharmacy sanctions for fraud, abuse or inappropriate billing. Intimate knowledge of pharmacy operations, third party billing & claim adjudication. Investigative or auditing experience a plus. Experience with word processors, spreadsheets & databases Special RequirementsIV. Job Skills / Requirements: 1. Thoroughness: Complete tasks 100% and pay attention to detail. Be willing to “go the extra mile” to follow through on audits, run down leads, “dig” for fraud and abuse. Properly and consistently adhere to standard auditing and investigative guidelines, document all findings and communications, and create a complete audit trail. Respond to all client requests. Let nothing “slip through the cracks.” 2. Communication: With good grammar and form, cohesively & concisely communicate written audit reports and work product documentation. Be able to verbally communicate in a professional & pleasant manner in potentially combative audit situations. 3. Confidence / Self Assuredness: Must be able to handle irritated or irate audit subjects and diffuse tense situations. Must be able to operate in a sometimes-tense environment and still reach objective of completing the audit. 4. Results Orientation: Take the initiative to tweak & redirect efforts in order to make the account successful. Chase down the leads that will yield the greatest degree of fraud and recoveries. 5. Flexibility: Must adapt and be able to handle a changing schedule and ranging responsibilities. 6. Problem-Solver: Must be able to think through complex situations and fraud schemes, and identify the pattern of abuse. Must be able to work independently and get the job done with minimal supervision. Full-time position requires up to 25% travel nationwideJob Experience:Pharmacy TechnicianExpected Travel Time: About 25% Company: ACS inc Location: Richmond, VA 23218 Job Status/Type: Full Time, Employee Job Category: Medical/Health Industry: Other/Not Classified Occupations: Pharmacy Career Level: Experienced (Non-Manager) Company: ACS inc Reference Code: 16685