Teams at Conduent

Audits pharmacy records against claims data to identify discrepancies, applies client instructions and pharmacy regulations, researches applicable laws, communicates audit results, and conducts onsite, desktop, and credentialing audits. The role requires CPhT certification or timely certification, retail pharmacy experience, local travel, a driver’s license, reliable transportation, Microsoft Office proficiency, and overnight travel up to 25%.

Investigate and determine correct Coordination of Benefits for members with multiple plans; verify eligibility and payer order; contact carriers, Medicare, providers and members; review EOBs; document findings in company systems; process COB correspondence; handle inbound/outbound calls; meet productivity and quality goals while maintaining HIPAA and regulatory compliance in a fully remote environment.

Designs scalable business and client-specific solutions by analyzing financial data, evaluating technology ecosystems, and aligning solutions with organizational strategy. Partners with sales, technical, practice, and delivery teams to develop solution strategies, negotiate with stakeholders, support implementation, and ensure alignment with budgets, timelines, regulations, and customer expectations. The role also drives innovation, continuous improvement, and data-informed decision-making across a global, matrixed organization.