Sample Pharmacy Auditor Resume

Posted in Auditor Resume Examples

Willie Beam
2516 Freedom Lane
Stockton, CA 95204
(123)-746-6125
[email]

Job Objective To enhance my skills and further my career by filling the position of Pharmacy Auditor in well-established organization.

Summary of Qualifications:

  • Remarkable experience in conducting Fraud, Waste, Abuse audits
  • Sound knowledge of hospital, drug and long-term care pharmacy operations
  • Wide knowledge of pharmacy reference data and healthcare coding
  • Good understanding of pharmacy laws and regulations
  • Proficiency in Microsoft Word, Excel and Access
  • Familiarity with pharmacy claim adjudication standards and procedures
  • Immaculate communication skills
  • Strong analytical and investigative skills

Work Experience:

Pharmacy Auditor, August 2005 – Present
Connolly, Inc, Stockton, CA

  • Reviewed pharmacy claims within the medical benefit for potential errors.
  • Developed claim edits, and reports of results.
  • Coordinated with providers i.e. hospitals, outpatient facilities, pharmacies etc.
  • Corroborated audit findings as per payer processing principles.
  • Communicated with management on audit findings and assisted with issue resolution.
  • Suggest improvements and recommendations to meet client satisfaction.

Pharmacy Auditor, May 2000 – July 2005
Cybercoders, Stockton, CA

  • Ensured that providers retained proper records as claimed.
  • Communicated with providers and customers to provide excellent service standards.
  • Followed audit procedures and identified incoherent claims.
  • Verified audit data through communication and interaction.
  • Ensured to provide authorized services.
  • Assimilated audit data to generate the audit reports.

Education

Bachelor’s Degree in Pharmacy, Graceland University, Independence, MO

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