Pharmacy Claims Coordinator

HCM Nexus Consulting · Cebu City, Central Visayas, Philippines

Location

Cebu City

Job Type

Full-time

Posted

June 28, 2026

Job Description

We're looking for a Pharmacy Claims Auditor to safeguard our claims data and prevent fraud. You'll conduct audits, analyze billing activities, and ensure compliance with regulations.
What Youll Do:

Conduct desk and on-site pharmacy audits.
Review claims for errors, discrepancies, or fraud.
Communicate with pharmacies to resolve billing issues.
Prepare audit reports and recommend corrective actions.
Document findings and ensure client invoicing accuracy.

What You'll Bring:

Bachelor's degree + 1 year pharmacy experience (Long Term Care, Specialty, or Mail Order a plus).
Pharmacy Technician license required; national certification preferred.
Strong knowledge of pharmacy practice, laws, and regulations.
Proficient in MS Office; SQL/SAS knowledge a plus.
Excellent analytical, problem-solving, and communication skills.

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