Walgreens Pharmacy Claims Auditor Resume Examples

Discover the essential tips and tricks for crafting a winning resume that will land you the coveted role of Pharmacy Claims Auditor at Walgreens. This comprehensive guide will delve into the key skills, experiences, and qualifications required for this position, as well as providing valuable insights into what hiring managers are looking for in a standout candidate. Learn how to effectively showcase your expertise in pharmacy claims auditing, regulatory compliance, and data analysis, while also highlighting your strong communication and problem-solving abilities. With this expert advice, you'll be well on your way to creating a resume that sets you apart from the competition and secures your spot as a top contender for this vital role within Walgreens' pharmacy team.

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Walgreens Pharmacy Claims Auditor Resume Example

Lucya Nibbe, Pharmacy Claims Auditor

lucya.nibbe@gmail.com

(791) 162-6879

123 Maple Street, Concord, NH 03301

Professional Summary

With over two years of experience as a Pharmacy Claims Auditor, I have developed a keen eye for detail and comprehensive understanding of the intricacies of pharmacy claims processes. My expertise in reviewing and analyzing claims data, identifying discrepancies, and ensuring compliance with regulatory requirements has been instrumental in improving the overall efficiency and accuracy of my past employers' pharmacy claims management systems. Collaborating effectively with cross-functional teams, I have consistently demonstrated excellent communication and problem-solving skills. My dedication to maintaining high standards of quality and accuracy has allowed me to make significant contributions to the optimization of pharmacy claims operations while continually expanding my knowledge of industry best practices.

Work Experience

Pharmacy Claims Auditor at New Hampshire Pharmacy Auditors, LLC, NH

Jan 2023 - Present

• Successfully audited over 2,000 pharmacy claims in 2021, identifying an error rate of 5% and recovering $200,000 in overpayments for insurance companies and employers.
• Reduced clients' average pharmacy claim costs by 10% through the implementation of a rigorous auditing process that focused on detecting billing errors, fraudulent claims, and improper dispensing practices.
• Led a team of 5 pharmacy auditors to achieve the highest accuracy rating (98%) among regional competitors, resulting in increased client satisfaction and a 15% growth in the company's customer base.
• Developed and implemented a streamlined audit reporting system that improved the efficiency of the audit process by 20%, enabling the team to complete audits 25% faster and increasing overall productivity.

Associate Pharmacy Claims Auditor at Granite State Pharmacy Claims Auditors, NH

Sep 2021 - Nov 2022

• Successfully identified and recovered $1.2 million in overpaid pharmacy claims within a 12-month period, reducing total claim overpayments by 15% for Granite State Pharmacy Claims Auditors, NH.
• Conducted comprehensive audits of over 500 pharmacy claims per month, resulting in the identification of billing discrepancies and the implementation of corrective actions to improve overall accuracy and efficiency.
• Streamlined the pharmacy claims auditing process by implementing data analysis techniques and tools, leading to a 20% reduction in audit completion time and a 10% increase in claim accuracy.
• Trained and mentored three new Associate Pharmacy Claims Auditors, improving team productivity by 25% and contributing to an overall increase in successful claim recoveries for the company.

Education

Bachelor of Science in Pharmacy at University of New Hampshire, Durham, NH

Sep 2017 - May 2021

Relevant Coursework: Pharmaceutical Chemistry, Pharmacology, Pharmacokinetics, Pharmacotherapy, Drug Design and Development, Medicinal Chemistry, Pharmaceutics, Biopharmaceutics, Pharmaceutical Analysis, Clinical Pharmacy, Pharmacy Management, and Pharmaceutical Regulations.

Skills

• Pharmaceutical knowledge
• Attention to detail
• Analytical skills
• Regulatory compliance
• Communication skills
• Time management
• Problem-solving

Certificates

• Certified Pharmacy Technician (CPhT)
• Certified Professional Biller (CPB)

Tips for Writing a Better Walgreens Pharmacy Claims Auditor Resume

1. Use a clear and concise format: Your resume should be easy to read and well-organized. Use headings, bullet points, and consistent formatting throughout the document to ensure your information is presented clearly.

2. Tailor your resume to the job posting: Carefully read the job posting for the Walgreens Pharmacy Claims Auditor position and tailor your resume to highlight relevant skills, qualifications, and experiences that match what they are looking for.

3. Start with a strong summary statement: Begin your resume with a brief summary statement that highlights your key qualifications for the position. This should include your experience in pharmacy claims auditing or related fields, as well as any specific skills or certifications you have that are relevant to the role.

4. Emphasize your relevant work experience: Focus on highlighting your work experience in pharmacy claims auditing or similar roles within the healthcare industry. Be sure to include any accomplishments or achievements that demonstrate your ability to excel in this field.

5. Highlight your education and certifications: Make sure to include any relevant degrees or certifications you hold, such as a degree in pharmacy or certification as a Pharmacy Technician.

6. Include specific examples of successes: In the work experience section of your resume, provide specific examples of successes you have had in previous roles related to pharmacy claims auditing. This could include identifying trends in claim errors, implementing process improvements, or training staff on proper claims submission procedures.

7. Showcase technical skills: As a pharmacy claims auditor, it's important to be proficient in various software programs used for managing claims data and conducting audits. Be sure to list any programs you're familiar with on your resume.

8.Green Key:

Use keywords from the job posting: Many companies use applicant tracking systems (ATS) which scan resumes for specific keywords related to the job description. Be sure to incorporate these keywords into your resume where appropriate.

9. Proofread carefully: A well-written resume free of grammatical errors and typos will make a strong impression on potential employers. Take the time to proofread your resume carefully before submitting it.

10. Keep it concise: A resume should be no longer than one or two pages in length. Focus on including only the most relevant and important information related to the Walgreens Pharmacy Claims Auditor position, and eliminate any unnecessary details.

In summary, a successful Walgreens Pharmacy Claims Auditor resume should clearly showcase your relevant skills, experiences, and qualifications for the role. By tailoring your resume to the job posting, using a clear format, and providing specific examples of your successes in the field, you can create a strong impression on potential employers.

Related: Claims Auditor Resume Examples

Key Skills Hiring Managers Look for on Walgreens Pharmacy Claims Auditor Resumes

When applying for a Pharmacy Claims Auditor position at Walgreens, it is crucial to incorporate keywords from the job description in your application materials. This is because Walgreens, like many other companies, uses Applicant Tracking Systems (ATS) to screen and filter applicants. These systems are designed to identify candidates who possess the skills, experience, and qualifications required for the role by scanning resumes and cover letters for specific keywords. By including these relevant terms in your application, you increase your chances of passing through the initial screening process and being considered for an interview. Therefore, carefully review the job description and ensure that you tailor your resume and cover letter to include important keywords such as "pharmacy claims auditing," "compliance," "regulatory requirements," and any other phrases or terminology that may be relevant to the position.

When applying for pharmacy claims auditor positions at Walgreens, you may encounter common skills and key terms such as prescription processing, drug utilization review, medical billing and coding, Medicare Part D, pharmaceutical regulations, and pharmacy benefit management.

Related: Claims Auditor Skills: Definition and Examples

Common Action Verbs for Walgreens Pharmacy Claims Auditor Resumes

Crafting a Walgreens Pharmacy Claims Auditor Resume can be a challenging task, particularly when it comes to finding the right action verbs to showcase your skills and achievements. Using the same verbs repeatedly can make your resume monotonous and fail to grab the attention of potential employers. To create a compelling and impressive resume, it is essential to incorporate a variety of action verbs that effectively demonstrate your expertise as a pharmacy claims auditor. These verbs should highlight your abilities in areas such as reviewing claims, ensuring compliance with regulations, identifying discrepancies, and communicating with stakeholders. By using diverse and powerful action verbs, you can significantly enhance the impact of your Walgreens Pharmacy Claims Auditor Resume and increase your chances of landing the job you desire.

To provide you with a competitive advantage, we have curated a list of impactful action verbs that will enhance your resume and help secure your next interview:

Related: What does a Claims Auditor do?