CPhT Certified Claims Analyst
Company: VirtualVocations
Location: Vista
Posted on: May 7, 2025
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Job Description:
A company is looking for a Claims Analyst - Remote US.
Key Responsibilities
Analyze pre-payment pharmacy claims data to identify potential
overpayments and ensure accurate claims processing
Audit pharmacy claims and documentation for reimbursement accuracy
and compliance with contract terms
Investigate claims issues, including overpayments and denials, and
collaborate with stakeholders to resolve them
Required Qualifications
Must be a Nationally Certified Pharmacy Technician (CPhT)
At least 2 years of experience in claims analysis, processing, or
auditing in healthcare
Experience in managed care, insurance, or pharmacy benefit
management preferred
Proficiency with pharmacy claims payment configuration systems and
MS Office, especially Excel and Access
Ability to recognize data discrepancies and perform root cause
analysis for process improvement
Keywords: VirtualVocations, Cathedral City , CPhT Certified Claims Analyst, Professions , Vista, California
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