What are the responsibilities and job description for the Senior Pharmacy Audit & Revenue Integrity Specialist position at Prorec Resource Solutions, LLC?
Location: Remote (U.S.) Occasional Travel (1-3 days)
Type: Contract (PT/FT, 1-6 month projects)
Rate: $65-$95/hr DOE
Summary
Seeking a Licensed Pharmacist to support national Pharmacy Audit and Revenue Integrity projects. Work includes reviewing pharmacy billing accuracy, evaluating drug pricing (AWP/WAC/U\&C), identifying discrepancies, and ensuring compliance with payer and regulatory standards. Mainly remote with short onsite visits; travel paid.
Key Duties
Type: Contract (PT/FT, 1-6 month projects)
Rate: $65-$95/hr DOE
Summary
Seeking a Licensed Pharmacist to support national Pharmacy Audit and Revenue Integrity projects. Work includes reviewing pharmacy billing accuracy, evaluating drug pricing (AWP/WAC/U\&C), identifying discrepancies, and ensuring compliance with payer and regulatory standards. Mainly remote with short onsite visits; travel paid.
Key Duties
- Conduct pharmacy billing and reimbursement audits
- Validate NDCs, pricing tables, invoice accuracy
- Identify discrepancies in UOM, pricing, fees
- Prepare audit summaries, documentation, and findings
- Ensure Medicare/Medicaid and regulatory compliance
- Collaborate with internal and external stakeholders
- Active U.S. Pharmacist license
- Experience with pharmacy audits or revenue cycle
- Strong understanding of drug pricing methodologies
- Detail‐oriented; strong analytical and documentation skills
- Ability to travel briefly when needed
- Public‐sector/government audit experience
- Medicare/Medicaid billing familiarity
Salary : $65 - $95