Sr. Specialist, Provider Support Services
About The Position
Being on medication is tough enough. We want to make getting it the easy part. Getting prescriptions to patients has become increasingly complex. When things get messy along the prescription journey, pharmaceutical manufacturers rely on us to untangle the process and create a clear path—allowing patients to build trusting relationships with their medication brands. We’re not only committed to taking the pain out of the prescription process, but we’re also devoted to bringing the brightest minds together under one roof. We bring together diverse voices—engineers, pharmacists, customer service veterans, developers, program strategists and more—all with one vision. Each perspective and experience makes ConnectiveRx better than the sum of its parts. The Sr. Specialist, Provider Support Services provides initial setup and ongoing support to ConnectiveRx internal and external clients, healthcare providers, and internal users of ConnectiveRx provider-facing self-service tools, including provider portals, EDI, and ACH. Daily activities include onboarding new practices, monitoring and troubleshooting inbound and outbound transactions, coaching healthcare provider offices on submission errors, and creating and providing daily activity reports to internal and external stakeholders. This role works closely with Product, Business Development, Program Management, and Patient Affordability Solutions to identify opportunities to expand feature utilization and adoption.
Requirements
- Bachelor’s degree or seven years of equivalent experience required.
- Three to five years of customer service, healthcare office support, or other healthcare-related experience.
- Knowledge of payer and provider billing software and clearinghouse integration.
- Knowledge of healthcare provider practices.
- Strong quantitative and analytical skills.
- Excellent oral, written, and grammatical communication skills.
- Ability to listen actively and communicate key issues respectfully.
- Understands the importance of sharing only relevant information.
- Ability to adapt communication style to different audiences and clearly articulate messages.
- Anticipates, identifies, and addresses customer and client needs, sometimes before they are voiced.
- Actively seeks ways to help others and demonstrates empathy and thoughtfulness.
- Responds promptly and courteously to ensure customer needs and concerns are addressed.
- Focuses on continuously improving service provided to both internal and external customers.
- Applies the technical knowledge and abilities required to achieve desired outcomes.
- Demonstrates technical proficiency within the scope of responsibilities.
- Understands the complexity of technical activities and provides appropriate guidance to others.
- Identifies opportunities to improve or redesign processes through technical solutions.
- Ability to comprehend and perform basic arithmetic.
- Adhere to all company policies, procedures, and required training consistent with ConnectiveRx’s Information Security and Compliance Programs, including SOC 1, SOC 2, PCI, and HIPAA requirements.
- Maintain strict compliance with company and client policies regarding business rules and ethics, as well as all applicable local, state, and federal laws and regulations.
Nice To Haves
- Travel may be required for client and/or ConnectiveRx meetings and training.
Responsibilities
- Collaborate with internal teams, including Program Management, and external partners to ensure alignment on claims processing goals, share reporting insights, and contribute to process improvement initiatives.
- Manage and troubleshoot EDI (Electronic Data Interchange) claim issues that are not processing correctly, create incident request tickets for identified issues, and respond to healthcare provider calls to resolve EDI submission problems and claim errors efficiently.
- Conduct daily monitoring of inbound and outbound EDI transactions, proactively identify irregularities, and ensure timely follow-up to maintain smooth claims processing.
- Assist in the setup and ongoing maintenance of EDI programs for assigned brands, ensuring configurations are accurate and updated to support seamless data exchange and claims operations.
- Maintain accurate and up-to-date documentation related to EDI processes, claim issues, resolutions, and communications with providers, ensuring easy reference and compliance.
- Utilize internal systems to track, report, and analyze claim data; support system enhancements; and ensure the accuracy and integrity of EDI processing through active system use and feedback.
Benefits
- medical, dental, vision, life, and disability insurance
- 401(k) plan, with employer contributions where applicable
- flexible paid time off (PTO) policy for exempt employees, covering sick days, personal days, and vacations
- eight standard company holidays and three floating holidays annually
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
