Pharmacy Auditor

Job Description Job Description

Job Title: Pharmacy Auditor

Location: Irvine, CA

Reports to: Program Supervisor/Solutions Manager

FLSA Status: Non-Exempt

About Our Organization: RIS Rx (pronounced "RISE Rx") is on a mission to make every dollar allocated for affordability count, delivering true impact for the patients and pharma manufacturers we serve. We've built the industry's first real-time, pharmacist-led GTN Revenue Performance platform, restoring trust, visibility, and integrity to patient affordability.

What sets us apart? Our team combines deep pharmacy roots with cutting-edge technology, tackling patient access barriers in smarter, more human ways. Our people-first culture means you'll find career growth, great benefits, and a supportive environment waiting for you, because we believe when people thrive, everyone wins.

Join us and help shape a better, brighter future for patient access.

Job Summary
As a Pharmacy Auditor at RIS Rx, you will provide essential operational support for various pharmacy programs. This role is critical to maintaining program integrity through accurate reporting, adherence to business rules, and clear communication with pharmacies. Your primary responsibility is to execute operational tasks efficiently while adhering to company standards.

Duties & Responsibilities

• Provide operational support across multiple pharmacy programs to ensure smooth and compliant program execution
• Monitor program activity to maintain integrity and identify discrepancies, trends, or potential compliance issues
• Prepare accurate reports and documentation to support internal stakeholders and program requirements
• Communicate clearly and professionally with pharmacy partners regarding documentation, discrepancies, and program expectations
• Collaborate cross-functionally with internal teams to resolve operational issues and improve workflow efficiency
• Maintain detailed records and ensure all activities align with regulatory requirements and company policies
• Escalate complex issues or compliance concerns appropriately and in a timely manner
• Contribute to process improvement initiatives to enhance reporting accuracy and operational effectiveness

Skills & Qualifications

• Critical thinking skills and investigative skills
• Interest in data analysis and reporting

Education/Experience:

• This position requires a High School Diploma or GED
• Bachelor's degree in healthcare administration, pharmacy, or related field preferred
• Extensive pharmacy processing experience
• This includes (and is not limited to) knowledge about adjudicating claims through third parties, insurance overrides, OCC codes, co-billing copay cards
• Familiarity with pharmacy workflow
• Data entry/processing, filling, verification, dispensing
• Pharmacy technician license preferred

What we offer:

• Free gym membership
• Modern office
• Annual merit-based salary increases
• 401(k) with annual company match
• Medical - RIS Rx covers 100% of the employee's base HMO medical plan
• Voluntary Dental, Vision & Life Insurance
• Flexible Savings Account (FSA)
• Paid Holidays
• Time off that grows with you:
• 3 weeks PTO 0-2 years
• 4 weeks PTO after 3+ years
• 5 weeks PTO after 5+ years
• Recognition programs that celebrate impact and results
• Mentorship and coaching opportunities
• Clear growth paths and career development support
• Fully stocked snack kitchen
• Company-paid lunches

Company Description Our fundamental pillars - Resilience, Innovation, Service - inspire us to overcome challenges, develop pioneering solutions and deliver exceptional support for life sciences organizations.

As a leader in the healthcare technology space, RIS Rx provides the transparency required for pharmaceutical manufacturers to make swift and intelligent financial decisions centered around patient well-being.

Delivering innovative solutions for patient prosperity.
At RIS Rx, we believe in delivering bespoke healthcare solutions that address unique patient and business needs. Our software integrates seamlessly with our customers' systems, ensuring better treatment outcomes and improved program efficiencies.

Our proprietary software and solutions are born out of deep industry knowledge and experience and allow RIS Rx to address the complex demands of today's healthcare systems. Company Description Our fundamental pillars - Resilience, Innovation, Service - inspire us to overcome challenges, develop pioneering solutions and deliver exceptional support for life sciences organizations. As a leader in the healthcare technology space, RIS Rx provides the transparency required for pharmaceutical manufacturers to make swift and intelligent financial decisions centered around patient well-being. Delivering innovative solutions for patient prosperity. At RIS Rx, we believe in delivering bespoke healthcare solutions that address unique patient and business needs. Our software integrates seamlessly with our customers' systems, ensuring better treatment outcomes and improved program efficiencies. Our proprietary software and solutions are born out of deep industry knowledge and experience and allow RIS Rx to address the complex demands of today's healthcare systems.