Client Support Specialist

ProCare Pharmacy Benefit Manager, Inc.; Gainesville, Northern (GA, KY); Hybrid; USD 45,000 - 65,000; Full time

Benefits offered by this job

Health benefits

Paid vacation

Wellness program

401(k) match

EAP

Referral program

Job summary

ProCare Pharmacy Benefit Manager, Inc. is seeking a Client Support Specialist to support plan benefits and client services, focusing on maintenance, changes, claims research and overall client satisfaction.

You will coordinate benefit design updates, assist with new group implementations, and work with cross-functional teams to ensure timely, accurate deliverables and strong client retention.

Qualifications

• Associates Degree preferred in Business or Healthcare, or equivalent background.
• Pharmacy tech or PBM experience is a plus.
• Proficient with Microsoft Office and related applications.
• Analytical, problem solving and critical thinking skills required.
• Self-motivated, able to work independently and in a fast-paced environment.
• Strong organizational and time-management abilities.
• Excellent verbal and written communication skills.

Responsibilities

• Provide backend support of plan design and benefit configuration to the Client Services team.
• Effectively manage plan changes and requests, with guidance on structures and setup.
• Analyze claims for proper payment and assist with plan changes.
• Assist in benefit setups and changes.
• Conduct regular service and relationship communications with clients.
• Identify, research, resolve, and follow up on service requests.
• Assist with system testing and quality assurance submissions.
• Maintain system user access for Account Managers and Clients.
• Manage system training for clients.
• Produce quarterly reporting and service level tracking.
• Develop knowledge of clients' objectives and plan designs and needs.
• Support internal workflow and suggest improved processes.
• Collaborate with cross-functional teams to address client needs.
• Utilize data and analytics tools to prepare reports and presentations.
• Apply project management and problem-solving skills.
• Support Go Live transitions with Implementation and ongoing Client Services.
• Maintain ProCareRx systems documenting client communications and information.
• Communicate with Client Services leaders and provide timely feedback on projects.
• Assist leadership with project management tasks.
• Contribute to team effort by performing other duties as assigned.

Skills

Analytical thinking

Problem solving

Communication skills

Teamwork

Education

Associates Degree in Business or Healthcare field

Tools

Microsoft Office

Job description

The Client Support Specialist will provide support with plan benefit changes and account support to the Client Services team with a focus on benefit maintenance, changes, claims research and overall client support. This position will be responsible for coordinating requested benefit design changes/updates and departmental claim and plan escalation requests. Assist with coordinating new group implementations and benefit plan changes. The CSS will work collaboratively with other central departments and stakeholders to solve complex problems, ensure all client deliverables are timely and accurate, and client needs are being met, to maintain client retention, renewal, and overall plan satisfaction.

Duties include but are not limited to:

• 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)

Qualifications and Requirements

• Associates Degree in Business or Healthcare field 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

Physical Demands

Requires sitting, standing, and occasional light lifting.

The Perks of Joining Our Team:

We believe in taking care of our team. You'll enjoy a comprehensive benefits package designed to support your well-being and financial future:

• Comprehensive Health Benefits:Medical, Dental, Vision, Short-Term/Long-Term Disability Insurance, Life insurance.


• Time to Recharge:Paid vacation and holiday pay.


• Focus on Your Wellness:We offer a robust Employee Wellness Program.


• Invest in Your Future:401 k with a company match.


• Support System:Employee Assistance Program provides confidential support and counseling.


• Get Rewarded for Referring Great People:Employee referral program.

ProCare Rx is an Equal Opportunity Employer.

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.