Overview

Shift : 9-5:30pm

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 Specialty Pharmacy Specialist manages specialty pharmacy triage processes on behalf of the manufacturer client. This individual works independently within a supervised team environment and is responsible for coordinating with specialty pharmacies to process referrals and generate status reports as needed. The role also includes conducting weekly update calls and maintaining an action log until all tasks are complete.

Responsibilities

Manage the specialty pharmacy process on behalf of the manufacturer client, including processing patient enrollments, managing discrepancies, addressing client and pharmacy inquiries, conducting weekly update calls, and providing regular reporting.
Work on complex issues requiring analysis and judgment to evaluate various factors and determine the best approach. Collaborate and network with key contacts outside of immediate areas of expertise.
Complete and submit insurance forms and electronic claims in a timely manner, using multiple communication methods such as phone, fax, mail, and online portals. Provide excellent customer service to both internal and external customers by resolving reimbursement issues, billing denials, claim errors, and other related matters.
Verify that transactions and processes comply with organizational and departmental policies, recommending changes or solutions as needed.
Perform related duties and special projects as assigned.

Qualifications

Education: High school diploma or GED required; Associate or Bachelor’s degree preferred.
Experience: Minimum of 3 years of experience; previous call center experience highly desired.
Knowledge: Understanding of managed care, insurance reimbursement, and patient advocacy preferred.
Skills: Experience with ConnectiveRx systems and CRM preferred. Knowledge of regulatory or quality system components. Proficient in computer use, multi-system navigation, and MS Office Suite (Outlook, Word, Excel, SharePoint, Teams).

Competencies

Communication: Demonstrates active listening and effective communication. Adapts messaging to different audiences to ensure clarity and respect.
Service Orientation: Anticipates and addresses customer needs proactively, demonstrating empathy and professionalism in all interactions. Strives to improve service quality for both internal and external customers.
Technical Utilization: Applies technical knowledge to achieve desired outcomes, demonstrates proficiency in relevant systems, and identifies opportunities to improve processes through technical solutions.

Travel or Physical Requirements

None

Compliance Requirements
Adhere to all company policies, procedures, and training consistent with ConnectiveRx’s Information Security and Compliance Programs, including but not limited to SOC1, SOC2, PCI, and HIPAA. Maintain strict compliance with company and client policies regarding business ethics and applicable local, state, and federal laws.

Compensation & Benefits: This position offers opportunities for a bonus (or commissions), with total compensation varying based on factors such as location, relevant skills, experience, and capabilities.

Employees at ConnectiveRx can access comprehensive benefits, including medical, dental, vision, life, and disability insurance. The company regularly reviews and updates its health, welfare, and fringe benefit policies to ensure competitive offerings. Employees may also participate in the company’s 401(k) plan, with employer contributions where applicable.

Time-Off & Holidays: ConnectiveRx provides a flexible paid time off (PTO) policy for exempt employees, covering sick days, personal days, and vacations. PTO is determined based on an employee’s first year of service. Employees also receive eight standard company holidays and three floating holidays annually, with prorations applied in the first year.

The company remains committed to providing competitive benefits and reserves the right to modify employee offerings, including PTO, STO, and holiday policies, in accordance with applicable laws and regulations.

Specialty Pharmacy Specialist

Overview

Responsibilities

Qualifications

Posted Salary Range

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