Works with our clients (and/or their auditors), governmental agencies such as CMS, the OIG, and their subcontractors and Client Audit management as well as other ESI subject matter experts to resolve audit issues noted during the client audit process. Assists Auditor Associate Support staff with performing their job duties. Tracks status and serves as main contact for clients during routine audits. Monitors contract terms to ensure clients are requesting appropriate data. Assists with troubleshooting issues and questions arising from client audits. Coordinates with IS department to obtain applicable electronic files for the client audits, ensuring all information is included and readable. Plans and performs on-site audits with assistance from Client Audit management. Performs pro-active contract audits.
Researches audit findings utilizing ESI systems.
Works with the cross functional departments to ensure issues are resolved and deadlines are met.
Assists with troubleshooting issues and questions arising from audits.
Prepares the response to the audit findings.
Discusses the audit with the client (and/or auditor), governmental agencies (and/or subcontractor), understanding and managing expectations and working through any limitations that may be experienced due to confidentiality of information, etc.
Must be able to anticipate the auditor's and client's needs.
Facilitates assigned on-site audits, which may include an operational review of various departments at ESI, prepping rebate and/or pharmacy contract information.
Tracks status and serves as main contact for clients during routine audits and monitors contracts to ensure clients are requesting appropriate data.
Performs pro-active contract audits using the Client Audit Resolution Tool.
Fields various requests for information.
This includes distributing appropriate SAS 70 reports, fulfills minimal claims reviews, replying to questionnaires about the company, etc.
Works directly with Legal and the client to resolve issues of confidentiality agreements and any other legal conflicts that may arise.
Works with accounting to coordinate payment information.
Ensures clients receive payments.
Special projects as assigned.
Bachelor's degree preferably with focus in Finance or other business related field or 6-8 years of relevant work experience.
0-2 years of relevant work experience preferably with 1-3 years of experience in financial analysis or auditing or 1-3 years of experience in PBM industry preferred.
Microsoft Office including Excel, Access, Word, and Outlook; Knowledge of Express Scripts systems and operations preferred.
Previous experience working with cross functional departments to research and resolve issues using innovative solutions.
Focus on quality and service.
Demonstrated ability to meet multiple deadlines and manage a dynamic workload, well organized.
Demonstrated analytical and problem solving skills.
Excellent verbal and written communication skills along with presentation skills.
Ability to handle sensitive or confidential information is critical.
Ability to work a flexible schedule to accommodate project deadlines.
Knowledge of Manual Claims preferred but not required
ABOUT THE DEPARTMENT
If your niche is in financial reporting and analysis, underwriting, cash management, audit, or investor relations, our Finance department may be a perfect fit for you. Our teams within Finance work together to ensure our spending stays on track, and that we remain a profitable industry leader. We're always on the lookout for innovative people who think outside the box to join our team.
ABOUT EXPRESS SCRIPTS
Advance your career with the company that makes it easier for people to choose better health.
Express Scripts is a leading healthcare company serving tens of millions of consumers. We are looking for individuals who are passionate, creative and committed to creating systems and service solutions that promote better health outcomes. Join the company that Fortune magazine ranked as one of the "Most Admired Companies" in the pharmacy category. Then, use your intelligence, creativity, integrity and hard work to help us enhance our products and services. We offer a highly competitive base salary and a comprehensive benefits program, including medical, prescription drug, dental, vision, 401(k) with company match, life insurance, paid time off, tuition assistance and an employee stock purchase plan.
Express Scripts is an equal opportunity employer / disability / veterans
Express Scripts is a VEVRAA Federal Contractor.