Client Success & Benefits Operations Specialist

Procare-Rx; Gainesville (FL); On-site; USD 42,000 - 65,000; Full time

Benefits offered by this job

Comprehensive Health Benefits

Time to Recharge

Focus on Your Wellness

Invest in Your Future

Support System

Employee referral program

Job summary

ProCare Rx in Gainesville, FL is seeking a Client Support Specialist to assist the Client Services team with plan benefit maintenance, changes, claims research, and overall client support. You will coordinate benefit design updates and manage escalations to ensure timely and accurate client deliverables and strong retention.

You will collaborate with cross‑functional teams and support go‑live transitions and ongoing plan changes.

Qualifications

• Associates Degree in Business or Healthcare preferred; or any combination of education and experience which would provide an equivalent background, managing business operations and/or customer relationships, ideally in Healthcare Operations.
• Pharmacy Tech or PBM experience a plus.
• Proficient in Microsoft Office and other exposure to industry-related applications and software.
• Prior employment in a position requiring use of analytical, problem solving, and critical thinking skills.
• Self-motivated, with the ability to work both independently, as well as cohesively within a team setting, with limited supervision in a fast-paced environment with timely turnarounds
• Exceptional organizational and time management skills
• Exceptional verbal and written communication skills to effectively communicate with peers, colleagues, and all levels of management

Responsibilities

• Provide backend support of plan design and benefit configuration to the Client Services team.
• Effectively manage plan changes and requests, while providing technical guidance on structures, analyze and review changes, and successfully implementing benefit changes/set up.
• Ability to logically evaluate claims for proper payment and assist as needed with plan changes.
• Assist in benefit setups and changes.
• Conduct regular service/relationship communications with clients.
• Identifying, researching, resolving, and providing prompt follow up to all service requests.
• Assist and coordinate with system testing and quality assurance submissions.
• Maintain systems user access for Account Managers and Clients.
• Manage system training for clients.
• Produce quarterly reporting and service level tracking.
• Develop and maintain a working knowledge of client\'s objectives, plan designs, and overall needs of clients.
• Understand and support all internal workflow, while providing ideas and suggestions for improved processes.
• Collaborate with cross-functional teams to represent client(s) internally and coordinate functions such as problem resolution, system implementations, project completion and/or to address ongoing pharmacy service needs.
• Utilizes various data and analytics tools to prepare reports, written communication, and/or presentations as needed.
• Employ project management and problem-solving skills.
• Work with the Implementation team to provide a smooth transition to ongoing Client Services following Go Live and with new plan changes and setup.
• Understand and support all internal workflow, while providing ideas and suggestions for improved processes.
• Maintain ProCareRx systems to assure documentation of client communications and client information is updated and accurate; includes but not limited to; new addresses, client contacts, plan notes, and documentation.
• Communicate regularly and as required with Client Services leaders, to provide necessary, timely feedback and assessment of active projects, and/or any relevant information/tasks.
• Assist leadership with project management tasks as needed.
• Contribute to a team effort by performing other duties as may be assigned (*see attachment)

Skills

Microsoft Office

Analytical skills

Problem solving

Critical thinking

Time management

Verbal communication

Written communication

Self-motivation

Team player

Education

Associates Degree in Business or Healthcare

Tools

Microsoft Office

Job description

ProCare Rx in Gainesville, FL is seeking a Client Support Specialist to assist the Client Services team with plan benefit maintenance, changes, claims research, and overall client support. You will coordinate benefit design updates and manage escalations to ensure timely and accurate client deliverables and strong retention.

You will collaborate with cross‑functional teams and support go‑live transitions and ongoing plan changes.