Description
About Us
At TELUS Health, we are at the forefront of innovative healthcare solutions in Canada. As a leader in integrated drug, dental, and extended health claims management, we are seeking a detail-oriented Pharmacy Drug Claims Auditor II to join our dynamic team and contribute to the integrity of our pharmacy claims processes.
We are looking for a Pharmacy Drug Claims Auditor II who combines in-depth knowledge of pharmacy operations with sharp analytical skills. This role is ideal for someone with a Pharmacy Technician background who is passionate about diving deep into the complexities of drug claims, identifying discrepancies, and driving process improvements.
What You will Do
Conduct comprehensive audits of pharmacy claims, examining and interpreting pharmacy records against submitted claim data for potential discrepancies
Validate claim documentation and systems data to ensure accurate processing in accordance with contractual and regulatory obligations
Analyze trends in pharmacy claims data to identify patterns, potential fraud, and areas for process improvement
Collaborate with pharmacies, insurance providers, and internal teams to resolve complex claim issues
Develop and implement strategies to enhance the efficiency and accuracy of the claims auditing process
Provide expert guidance on pharmacy-related matters to other departments within TELUS Health
Stay current with pharmacy regulations, drug formularies, and industry best practices
Qualifications
What You Bring
Pharmacy Technician certification with 3+ years of experience in pharmacy operations or claims processing
In-depth understanding of pharmacy drug claims processes, including billing procedures and common discrepancies
Strong analytical and problem-solving skills, with the ability to think critically about complex claims issues
Excellent attention to detail and the ability to manage large volumes of data accurately
Proficiency in data analysis tools and pharmacy management software
Outstanding communication skills, both written and verbal, with the ability to explain technical findings to various audiences
Demonstrated ability to work independently and as part of a team
Commitment to continuous learning and staying updated on pharmacy industry trends and regulations
Strong analytical skills and attention to detail
Self-motivated and results-oriented, with a strong drive to achieve program targets
Proficiency in Microsoft Office Suite and Google Suite, including Excel, PowerPoint, Google drive, Google sheets, required
Excellent communication and interpersonal skills
Ability to work independently and collaboratively in a fast-paced, dynamic environment.
Ability to travel within Canada as needed by the business, required
Hold a valid driver’s license, required
Bilingual, an asset
Why TELUS Health?
Opportunity to apply your pharmacy expertise in a dynamic, technology-driven environment
Flexible work arrangements through our TELUS Work Styles program
Competitive salary and comprehensive benefits package
Continuous learning and development opportunities in healthcare technology and claims management
Collaborative work environment that values innovation and process improvement
If you are ready to leverage your pharmacy background and analytical skills to make a significant impact on the integrity of drug claims processing, we want to hear from you. Join us in our mission to improve healthcare outcomes for Canadians through innovative claims management solutions.
By applying to this role, you understand and agree that your information will be shared with the TELUS Group of Companies’ Talent Acquisition team(s) and/or any leader(s) who will be part of the selection process.
