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Pharmacy Benefit Claims Auditor / Recovery Specialist

Active

State & Local

Response Deadline09/11/2026, 08:00:00 PM UTC

Contract Overview

Solicitation details, issuing organization, response deadlines, documents, and interested companies for this government contract opportunity.

AI Contract Overview

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The Pharmacy Benefit Claims Auditor / Recovery Specialist subcontract involves performing detailed analysis of pharmacy benefit claims for prime contractors on Kentucky Employees Health Plan projects. The selected provider will utilize PBM data analytics tools to identify inaccurate billing, fees, pricing, and member cost shares in near real time, ensuring all billing aligns with contractual terms and plan designs. The role requires specialized knowledge of pharmacy billing standards and strict compliance with the Kentucky Civil Rights Act and KRS tax laws to deliver comprehensive audit reports and recovered savings. This opportunity is managed by the Kentucky Personnel Office of Secretary and is based in Frankfort. The solicitation was posted on September 4, 2026, with a response deadline of September 11, 2026. The contract falls under NAICS code 541219 and is structured as a subcontract.

General Info

Subcontract for pharmacy benefit claims auditing and recovery for Kentucky Employees Health Plan.

Agency

Kentucky → Personnel-Office of SecretaryView Agency

NAICS

541219 - Other Accounting ServicesView NAICS

Place of Performance

Frankfort, KY, USA

Set-Aside

NONE

Documents

This scope was carved out of RFP 790 2700000038.

The full solicitation package (8 documents), including the RFP, is on the prime solicitation, not on this scope.

View the prime solicitation

RFP-790-2700000038-2 | Pharmacy Benefit Claims Monitoring

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Timeline

PostedSep 4

subcontract

Response DeadlineSep 11

Submission deadline

Response Deadline

09/11/2026, 08:00:00 PM UTCin 7 days

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Organization & Contact Information

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AgencyKentucky → Personnel-Office of Secretary

ContactsNo contacts available

OfficeN/A

Organization / Agency

Kentucky → Personnel-Office of Secretary

View Agency Profile

Office AddressN/A

ContactsNo contact information available

Full Description

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Performs detailed analysis of pharmacy benefit claims for prime contractors on Kentucky Employees Health Plan (KEHP) projects. Analyzes claims data to identify inaccurate billing, fees, pricing, or member cost shares in near real time. Validates billing against contractual terms and plan designs using PBM data analytics tools. Requires knowledge of pharmacy billing standards and compliance with Kentucky Civil Rights Act and KRS tax laws. Delivers audit reports and recovered savings.

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