Certified Pharmacy Technician

Company: GHR Healthcare
Location: Philadelphia
Posted on: May 18, 2025

Job Description:

The Ambulatory Regulatory Technician is responsible for helping to manage the internal and external pharmacy payer audits and requirements in accordance with Federal, State and Internal auditing standards. The Ambulatory Regulatory Technician will assist in the day-to-day activity of the outpatient pharmacy locations insurance audit requests, as well as proactive audits and regulatory compliance. The Ambulatory Regulatory Technician services more than 6+ retail pharmacy locations in both Philadelphia and suburban locations. In addition to data compilation for fax or electronic audit, the auditing technician will support the managers during in person audits, proactively audit claims for accuracy and support needed regulatory requirements. The purpose of the Ambulatory Regulatory Technician is to help drive overall fiscal and regulatory performance and manage the daily activities of the insurance payer programs. Key responsibilities will include ensuring timeliness of payer audit completion, ensuring accuracy of information submitted, assessing the risks in the pharmacy audit assignment, perform appropriate audit procedures, draft and communicate audit findings and observations and collaborate with pharmacy management to resolve issues in a timely and efficient manner.

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--- Conducts desktop and onsite audits for the HUP Pharmacies and in accordance with Federal, State, and Internal Audit standards --- Proactive claims auditing to ensure the appropriateness and accuracy of submitted pharmacy claims --- Handling third-party requests in coordination with the Pharmacy Managers --- Auditing delivery processes to ensure medications are delivered and receipts are on record --- Within the general guidelines provided by management, will conduct the following tasks: assess the risks in the pharmacy audit assignment, perform appropriate audit procedures, draft and communicate audit findings and observations, and collaborate with pharmacy management to resolve issues in a timely and efficient manner --- Assists with ongoing regulatory compliance and accreditation surveys and monitors compliance with billing practices and collection of copays --- Leads meetings in conjunction with management and performs quality assurance checks of pharmacy payer documentation to ensure accuracy and completeness. --- Completion of payer regulatory requirements --- Performs duties in accordance with Penn Medicine and entity values, policies, and procedures --- Other duties as assigned to support the unit, department, entity, and health system organization

Job Types: Full-time, Contract

Pay: $22.69 - $23.98 per hour

Benefits:
* 401(k)
* 401(k) matching
* Dental insurance
* Employee discount
* Flexible schedule
* Health insurance
* Paid time off
* Vision insurance
Physical Setting:
* Outpatient
Schedule:
* 10 hour shift
* Day shift



Shift availability:
* Day Shift (Preferred)

Ability to Commute:
* Philadelphia, PA 19102 (Required)

Ability to Relocate:
* Philadelphia, PA 19102: Relocate before starting work (Required)

Work Location: In person

Keywords: GHR Healthcare, Catonsville , Certified Pharmacy Technician, Professions , Philadelphia, Maryland