Medical Claim Auditor

Introduction At Gallagher Benefit Services, you’re a trusted partner to organizations navigating some of their most important people decisions. We help clients build better workplaces, where people feel supported, empowered, and inspired to thrive. Whether it’s shaping benefit strategies, designing wellbeing programs, or advising on workforce challenges, the work you do here creates meaningful change for businesses and the people who power them. We’re a community of bold explorers, trusted experts, and compassionate partners; working side by side to solve problems, and shape the future of work. Here, curiosity is encouraged, collaboration is second nature, and your ideas have room to grow. If you’re looking for a place where your contribution matters and where you can help build a better world of work; think of Gallagher. How you'll make an impact Responsible for leading complex pharmacy claim audits, ensuring compliance with client‑specific requirements, and delivering advanced data analysis to identify trends, risks, and opportunities for improvement. This role involves managing high‑risk audits, investigating fraud or discrepancies, and presenting comprehensive reports with actionable recommendations. The Senior Analyst/Auditor provides strategic insights through advanced data analysis, predictive modeling, and the development of sophisticated dashboards to support client decision‑making and cost‑saving initiatives. Acting as a trusted advisor, this role manages senior‑level client relationships, leads discussions on audit findings, and collaborates on customized strategies to optimize pharmacy operations. Additionally, the position includes mentoring junior team members, reviewing deliverables, and driving team projects to enhance audit processes and tools. With expertise in regulatory compliance, including HIPAA, the Senior Analyst/Auditor ensures adherence to industry standards and provides guidance to clients and internal teams. This role also focuses on continuous improvement, innovation, and strategic initiatives to enhance client satisfaction, operational efficiency, and risk management. About You Required Typically requires a University Degree or equivalent experience and minimum 5 years of prior relevant experience. Proven experience in managing client relationships and delivering high‑quality client services. Strong background in pharmacy benefit management (PBM) processes and systems. Extensive experience with data analysis tools (e.g., Excel, SQL, Tableau, Power BI). Preferred Degree in Healthcare Administration, Business, Data Analytics, or a related field. Advanced analytical and problem‑solving skills with the ability to interpret complex data sets. Exceptional written and verbal communication skills, with the ability to present findings and recommendations to senior stakeholders. Strong project management skills, with the ability to manage multiple priorities and meet deadlines. Proficiency in Microsoft Office Suite (Excel, Word, PowerPoint) and data visualization tools. Work Traits Demonstrates in‑depth knowledge of pharmacy operations, billing practices, and regulatory requirements. Strong leadership and mentoring skills, with the ability to inspire and develop team members. Compensation and benefits We offer a competitive and comprehensive compensation package. The base salary range represents the anticipated low end and high end of the range for this position. The actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. On top of a competitive salary, great teams and exciting career opportunities, we also offer a wide range of benefits. Minimum core benefits you’ll get, depending on your job level these benefits may improve: Medical/dental/vision plans, which start from day one! Life and accident insurance 401(K) and Roth options Tax‑advantaged accounts (HSA, FSA) Educational expense reimbursement Paid parental leave Other benefits include: Digital mental health services (Talkspace) Flexible work hours (availability varies by office and job function) Training programs Gallagher Thrive program – elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing Charitable matching gift program And more… The benefits summary above applies to full‑time positions. If you are not applying for a full‑time position, details about benefits will be provided during the selection process. We value inclusion and diversity Click Here to review our U.S. Eligibility Requirements Inclusion and diversity (I&D) is a core part of our business, and it’s embedded into the fabric of our organization. For more than 95 years, Gallagher has led with a commitment to sustainability and to support the communities where we live and work. Gallagher embraces our employees’ diverse identities, experiences and talents, allowing us to better serve our clients and communities. We see inclusion as a conscious commitment and diversity as a vital strength. By embracing diversity in all its forms, we live out The Gallagher Way to its fullest. Gallagher believes that all persons are entitled to equal employment opportunity and prohibits any form of discrimination by its managers, employees, vendors or customers based on race, color, religion, creed, gender (including pregnancy status), sexual orientation, gender identity (which includes transgender and other gender non‑conforming individuals), gender expression, hair expression, marital status, parental status, age, national origin, ancestry, disability, medical condition, genetic information, veteran or military status, citizenship status, or any other characteristic protected by applicable federal, state, or local laws. Equal employment opportunity will be extended in all aspects of the employer‑employee relationship, including, but not limited to, recruitment, hiring, training, promotion, transfer, demotion, compensation, benefits, layoff, and termination. In addition, Gallagher will make reasonable accommodations to known physical or mental limitations of an otherwise qualified person with a disability, unless the accommodation would impose an undue hardship on the operation of our business. #J-18808-Ljbffr Arthur J. Gallagher & Co. (AJG)