IntePros is looking for a Program Support Specialist to join our Global Healthcare client in Orange, CA. The Program Support Specialist manages and coordinates the complete enrollment or disenrollment process of pharmacy customers into or out of our client's Provider Network and Accelerate Central Pay Services. The Specialist's responsibility for placing funds on hold. Associate will serve as the escalation point for customer issues, the liaison to reconciliation vendors, a contact point for Central Pay vendor partners and pharmacy benefit managers (PBMs), and the back-up for daily funds release to central pay customers. The associate will also assist with accounting/reconciliation issues for customers and the processing of refunds to PBM's or billing recoveries from customers.
PRIMARY DUTIES AND RESPONSIBILITIES:
1. Coordinates the complete Central Pay Services implementation for pharmacy customer enrollment or dis-enrollment in the Provider Network.
2. Confirms and loads pharmacy customer information and holds on funds into the Central Pay website.
3. Aids customers with Central Pay website issues.
4. Confirms customers have entered banking information and monitors banking status on website.
5. Monitors accounts to identify outstanding debts
6. Tracks down missing checks and 835's from PBMs
7. Locate and contact customers regarding outstanding debts.
8. Serves as escalation point for Central Pay issues.
9. Serves as liaison with Reconciliation Vendors and FDS payment processor.
10. Serves as contact person for Central Pay vendor partners and Pharmacy Benefit Managers (PBMs).
11. Aids pharmacy customers with questions and issues including accounting/reconciliation issues/funds on hold/debts.
12. Processes refunds for PBMs, funds on Hold and serves as back up for daily funds release.
13. Updates pharmacy customers' account records and collection efforts
14. Documents processes and procedures.
15. Completes special projects as assigned.
16. Performs related duties as required.
EXPERIENCE AND EDUCATIONAL REQUIREMENTS:
Completion of a four year bachelor's degree or equivalent work experience; Experience in retail pharmacy support, including knowledge in dealing with PBM claims processing, payment processing and reconciliation, preferred.