Pharmacy Auditor Resume
Objective : As a Pharmacy Auditor, responsible for conducting and reporting GCP audits and being able to make decisions independently. Able to practice independently according to the agreement with the manager.
Skills : Data management, Team leadership.
Description :
- Reviewed audit reports and provided technical assistance to the medical team.
- Supported management in areas of continuous improvement.
- Provided management with updates on the status of work, initiatives, and projects, as required.
- Reviewed audit results with the coordinator and other assessment team members.
- Coordinated audit activity with team members and liaised with clients regarding audit activity.
- Facilitated answers to questions from pharmacy network providers on a rotational basis
- Verified and documented evidence of compliance and non-compliance.
Experience
0-2 Years
Level
Entry Level
Education
Bachelor's Degree In Pharmacy
Senior Pharmacy Auditor Resume
Summary : As a Pharmacy Auditor planned and executed comprehensive audits of clinical trials. This includes auditing clinical trial master files, internal processes, investigator sites, and contract research organizations.
Skills : Strong verbal communication, Self-motivated.
Description :
- Assisted clients with questions relevant to the audit and/or certification process.
- Developed and maintained quality assurance documentation, including audit plans, audit reports, inspection readiness plans, and other relevant documents.
- Ensured accurate and timely documentation of audit findings, observations, and corrective actions taken.
- Communicated with providers to gather information for audits, educate on claim submission practices, and respond to queries in regard to audit results
- Assessed provider documentation to ensure compliance with enrolment agreement, benefit plan design, and provincial regulations.
- Calculated the adjustments required to correct claim transactions.
- Prepared, coordinated, and traveled to conduct the on-site audit at the provider’s location, and completed the post-on-site audit activities.
Experience
10+ Years
Level
Senior
Education
Bachelor's Degree In Healthcare Administration
Pharmacy Auditor Resume
Summary : As a Pharmacy Auditor, provided support in coordinating the preparation and conduct of the audit/inspection, and in developing the responses (CAPA) to any findings. Helped oversee the daily operations of pharmacy claims, Pharmacy Benefit Manager (PBM) audits, monitoring pharmacy adjudication trends, and team education.
Skills : Conflict resolution, Pharmacy, Customer records management.
Description :
- Compiled and produced audit reports that were detailed and unbiased
- Performed self and peer-review to ensure the accuracy and quality of claim reviews
- Tracked audit activity and summarized results of claim analysis and recoveries on a daily and/or monthly basis for department statistics for presentation to customers
- Identified trends observed from claim reviews and provided recommendations for risk criteria changes and/or candidates for a desk or on-site audit.
- Recommended incremental and continuous ideas that will increase the ability to prevent and manage risks that will bring the most value to customers.
- Responded to internal and external customer questions professionally, timely, and accurately.
- Assisted with the review of PBM contract(s) and contributed suggestions for improvement, based on knowledge of industry.
Experience
7-10 Years
Level
Management
Education
Bachelor's Degree In Business
Pharmacy Auditor Resume
Objective : As a Pharmacy Auditor, ensured that filled prescriptions were billed in accordance with the negotiated insurance rates. Worked closely with assigned pharmacies to certify that prescriptions are dispensed and claims are filed within the appropriate states rules and regulations.
Skills : HIPAA, Pharmacy Knowledge, Auditing Skills.
Description :
- Leveraged the company’s reporting systems to conceptualize, design, and distribute both operational and analytical reports focused on pharmacy utilization and cost.
- Assisted with developing, documenting, and evaluating the business requirements associated with data flows to and from the PBM and other vendors.
- Identified issues and resolutions, and consulted management on potential solutions to facilitate critical decisions.
- Generated audit reports and consulted with clients on the findings.
- Provided analytical expertise in the development of pharmacy-focused reporting and assessment of the impacts of benefit design changes.
- Documented and maintained pharmacy audit policies to ensure alignment with all regulatory requirements.
- Collaborated with internal stakeholders to support all internal and external audits of pharmacy vendors.
Experience
2-5 Years
Level
Executive
Education
Bachelor's Degree In Pharmacy
Junior Pharmacy Auditor Resume
Objective : As a Pharmacy Auditor, built, developed, and grew business relationships vital to the success of each audit project, which includes implementing, executing, and finalizing with strict deadlines.
Skills : Regulatory Compliance, Data Analysis, Communication.
Description :
- Coordinated all audit deliverables from pharmacy vendors and ensured submissions met audit deliverables.
- Drafted, tracked, and troubleshooted issues for all internal/external audit plans, including reporting and data files.
- Reviewed all audit results and created/managed any corrective action plans with pharmacy vendors.
- Assisted with developing new contract performance and compliance reporting.
- Identified and implemented process improvements to ensure pharmacy vendor compliance with regulatory requirements.
- Served as the pharmacy subject matter expert for accreditation and audit activities.
- Worked with vendors to ensure all documents and required information were received for audits and compliance validations.
Experience
0-2 Years
Level
Junior
Education
Bachelor's Degree In Healthcare Administration
Pharmacy Auditor Resume
Objective : As a Pharmacy Auditor, analyzed healthcare data from multiple sources, Tracked utilization and spending across services, Provided medication cost forecasting and trend analysis, and Identified high-risk members or groups for cost savings strategies, clinical interventions, and/or care management.
Skills : Attention to Detail, Pharmacy Software, Problem-Solving.
Description :
- Assisted in the operations of the Pharmacy through audit management.
- Oversaw pharmacy payor-directed audits by collecting transactional records and informational data and submitting data by deadlines.
- Maintained audit records to track recovery amounts.
- Ensured PBM auditing processes met all regulatory and client contractual requirements.
- Provided audit trending reports to leaders and internal stakeholders.
- Audited pharmacy claims in a pre-pay status, identifying deviations for outreach to the pharmacy team for education and correction.
- Summarized, reported, and communicated key discoveries and audit results to the team and other departments.
Experience
0-2 Years
Level
Fresher
Education
Bachelor's Degree In Business
Assistant Pharmacy Auditor Resume
Objective : As a Pharmacy Auditor, responsible for ensuring the pharmacy benefits manager (PBM) and specialty pharmacy vendors are compliant with contract requirements and supporting all internal and external audits of the pharmacy program.
Skills : Ethical Conduct, Documentation.
Description :
- Provided insurance navigation, rejection, and technical difficulty education to the team.
- Participated in the education of pharmacy students and new employees as documented by signature on the objectives and competencies form.
- Built and maintained relationships with internal business units and pharmacy service providers.
- Played a key role in assessing compliance with industry regulations, ensuring the integrity and accuracy of pharmaceutical operations.
- Collaborated with cross-functional teams to design and implement process improvements, resulting in increased efficiency and cost savings.
- Conducted internal audits, identifying and rectifying discrepancies in medication dispensing and inventory management.
- Assisted in the preparation for external audits, ensuring the organization's readiness and success in passing regulatory inspections.
Experience
2-5 Years
Level
Executive
Education
Bachelor's Degree In Pharmacy
Pharmacy Auditor Resume
Summary : As a Pharmacy Auditor, worked in close coordination with plant accountants to have plant-wise cost analysis and related control reports of preparation and various MIS reports with respect to costing and controls. Also, audit for completing cost audit in time and ensure correct cost updating in the system for proper valuation of inventory.
Skills : Inventory Management, Communication.
Description :
- Supported the pharmacy team in adhering to controlled substance handling and dispensing protocols.
- Contributed to staff training programs to maintain and improve regulatory compliance awareness.
- Maintained meticulous documentation and records of audit findings and corrective actions taken.
- Conducted routine and special audits of pharmacy operations to ensure compliance with federal, state, and local regulations.
- Reviewed pharmaceutical inventory records to verify accuracy and identify discrepancies in stock levels.
- Examined prescription and dispensing records to confirm that they aligned with established protocols and guidelines.
- Collaborated with pharmacy staff to provide education and training on compliance best practices.
Experience
7-10 Years
Level
Consultant
Education
Bachelor's Degree In Healthcare Administration
Pharmacy Auditor Resume
Objective : Dedicated and detail-oriented Pharmacy Auditor with 4 years of experience in conducting comprehensive audits to ensure compliance with regulatory standards and maximize operational efficiency.
Skills : Time Management, Detail-Oriented, Pharmacy Software.
Description :
- Developed and implemented corrective action plans to address audit findings and improve operational procedures.
- Maintained comprehensive audit reports, including findings, recommendations, and follow-up actions.
- Stayed current with evolving pharmacy regulations and made proactive adjustments to audit protocols.
- Utilized data analysis and auditing software to streamline the audit process and enhance accuracy.
- Visited assigned pharmacies and performed announced or unannounced billing audits of previously filed claims.
- Performed remote mini-audits to encourage continued compliance.
- Observed pharmacists to ensure they were dispensing medication within guidelines.
Experience
2-5 Years
Level
Executive
Education
Bachelor's Degree in Pharmacy
Pharmacy Auditor Resume
Summary : As a Pharmacy Auditor, reviewed the accounting and financial operations of a pharmacy managed and run by hospitals and healthcare centers. Performed audits on the inventory of the pharmacy store, financial systems, and control policies on regulated drugs and medicines.
Skills : Extremely organized, Conflict resolution.
Description :
- Inspected inventory and pharmacy computer programs for accuracy and discrepancies.
- Ensured all equipment is in proper working order and in compliance with industry standards.
- Completed pre-audit work including travel planning, materials gathering, and desk audit activities independently and in accordance with established objectives.
- Performed onsite and desktop pharmacy network audits to identify potential discrepant pharmacy claims.
- Assessed pharmacy site’s physical premises, compliance with regulatory requirements, and completeness of records.
- Gathered and reviewed documentation up to but not including prescription hardcopies, signature logs, compounding records, and MARs.
- Reported findings to pharmacy network providers and reviewed the quality and accuracy of audits conducted (QC).
Experience
7-10 Years
Level
Management
Education
Bachelor's Degree In Healthcare Administration
