Systems Support Specialist

Are you interested in joining a rapidly-growing, dynamic Pharmacy Benefit Management company working in a full-plate plus environment?  SOUTHERN SCRIPTS, LLC is growing and looking for incredible talent!  Southern Scripts, LLC provides comprehensive pharmacy benefit management services and healthcare plans for employers. We offer a Prescription Benefit Management option that restores balance between the need for sound prescription management strategies and meeting the health needs of a company's employees and their families.

Currently, we are experiencing accelerated growth in a rapidly changing industry. There's never been a better time to join our team. We are seeking motivated, coachable, self-driven individuals that possess a servant leadership philosophy and are looking for long term positions at Southern Scripts, LLC.

Role and Responsibilities

The System Support Specialist provides Southern Scripts employees and customers with comprehensive knowledge of the claim processing system and the support needed to answer questions and assist with problem resolution.  This position may also provide back up to the Customer Support team in answering incoming calls and providing 1st level support during high call volume periods.

• Actively communicates with Plan Design Technicians during "transition phase" to learn about the oncoming groups and any unique builds. Participation includes asking questions to gain a thorough understanding of the clinical intricacies of the group build and speaking up when potential issues/questions arise.
• Performs ongoing clinical testing and resolution after transition phase from the Benefit Design Technicians.
• Coordinates and leads internal meetings, phone calls, and discussions regarding clinical tasks/projects and timelines for claims processing tasks/projects.
• Initiates communication and coordinates with internal Southern Scripts Clinical team to send/receive the necessary information and documents needed to complete a task/project efficiently and accurately.
• Manages tickets within a ticketing system; accepts, tracks, responds to, and closes tickets assigned to this role in a timely and accurate manner.
• Updates Axis with clinical support notes and other information regarding the rules or other clinically associated benefits built into the system after the transition phase.
• Configures additional clinical rules/programs for existing groups after the transition phase.
• Configures requested clinical benefit changes for upcoming plan renewals.
• Performs testing and resolution of all clinical additions/changes made within the system.
• Documents the intricacies of unique clinical program builds/rules for future troubleshooting, editing, and training purposes.
• Runs periodic Clinical SOC Audit test claim files through after the transition phase.
• Troubleshoots and identifies technologically sound solutions to clinical claims processor questions/concerns for existing groups after the transition phase. May reach out to the group builder for help resolving an error/issue.
• Loads Grandfathering Files for groups after the transition phase.
• May lead projects assigned to Data Entry Specialists for inputting of data into the claims processor and/or Axis.
• NOT outward facing. Serves as the claims processor system knowledgeable support for the Southern Scripts Account Management team builds administrative requests within the system.
• Actively communicates with Plan Design Technicians during "transition phase" to learn about the oncoming groups and any unique builds. Participation includes asking questions to gain a thorough understanding of the administrative intricacies of the group build and speaking up when potential issues/questions arise.
• Performs ongoing administrative testing and resolution after transition phase from the Benefit Design Technicians.
• Coordinates and leads internal meetings, phone calls, and discussions regarding Account Management and/or Administrative tasks/projects and timelines for claims processing tasks/projects
• Initiates communication and coordinates with internal Southern Scripts teams (such as Account Management, Data Integration Specialists, Accumulation Specialists, etc.) to send/receive the necessary information and documents needed to complete a task/project efficiently and accurately.
• Manages tickets within a ticketing system; accepts, tracks, responds to, and closes tickets assigned to this role in a timely and accurate manner.
• Updates Axis with account management support and administrative notes and other information regarding the rules or other clinically associated benefits built into the system after the transition phase.
• Configures additional administrative rules/programs for existing groups after the transition phase.
• Configures requested administrative benefit changes for upcoming plan renewals.
• Performs testing and resolution of all administrative additions/changes made within the system.
• Documents the intricacies of unique administrative program builds/rules for future troubleshooting, editing, and training purposes.
• Runs periodic administrative SOC Audit test claim files through after the transition phase.
• Troubleshoots and identifies technologically sound solutions to account management and/or administrative claims processor questions/concerns for existing groups after the transition phase. May reach out to the group builder for help resolving an error/issue.
• May lead projects assigned to Data Entry Specialists for inputting of data into the claims processor and/or Axis.
• Performs accumulator audits with TPA, meeting SOC requirements.
• Works closely with the Eligibility Specialist (and serves as backup to Eligibility) to identify and resolve eligibility questions/issues.
• Works closely with Accumulation Specialists to identify and resolve accumulation questions/issues.
• PARTIALLY outward facing may communicate with TPAs when necessary, but usually goes through Data Integration Specialist, Eligibility Specialists, and/or Accumulation Specialists.
• Backup To: Systems Support Clinical, Eligibility Specialist, Accumulation Specialist
• Abide by all obligations under HIPAA related to Protected Health Information (PHI).
• If a HIPAA violation is discovered, whether individually or by another, you must report the violation to the Compliance Officer and/or Human Resources.
• Attend, complete, and demonstrate competency in all required HIPAA Training offered by the company.

Required Skills and Competencies

• Customer Focus
• Organization
• Time Management
• Leadership
• Strong Problem Solving Skills
• Strong communication/collaboration skills
• Easily adapt to and learn new technology and skills
• Thoroughness

Position Type and Expected Hours of Work

This is a full-time, salaried position. Days and hours of work are Monday through Friday, 8:00 a.m. to 5:00 p.m., with occasional after-hours or weekend duties.  

Qualifications and Education Requirements

• Associate degree preferred
• 5 years' previous experience with Customer Service
• 1-2 years' previous experience working in PBM environment or managed healthcare services organization
• Intermediate or advanced proficiency with MS Excel, Word, PowerPoint, Project, Outlook, and Adobe
• Excellent verbal and written communication skills, establishing rapport and working with others

Southern Scripts, LLC provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.