Auditing Clerk

Description We are looking for an Auditing Clerk to support a focused review of recently processed pharmacy claims in New York, New York. This Contract position will help examine claim activity, confirm documentation accuracy, and identify irregularities related to prescribing, billing, and reimbursement practices. The ideal candidate brings at least 2 years of audit experience and can work carefully through detailed records while maintaining compliance with applicable standards.

Responsibilities:
• Review a targeted group of recently paid pharmacy claims to assess accuracy, completeness, and adherence to audit guidelines.
• Examine prescription-related records such as original scripts, electronic orders, transfer documentation, delivery confirmation, signature logs, and compounding support files.
• Analyze claim activity for unusual prescribing trends, referral relationships, override usage, ingredient cost discrepancies, geographic prescribing patterns, and payment ...