Client Operations Specialist

LucyRx

. Manage texts, service emails, incoming calls, and voicemail .

Posted 11/2/2026full-timeRemote • United StatesMid-LevelSenior💰 $25 - $29 per hourWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in managing pharmacy benefits and prior authorization processes, with strong capabilities in data entry, claims resolution, and client support. Proficient in communication and collaboration across teams to ensure accurate and timely service delivery.

Highest-signal resume keywords

Pharmacy Benefits ManagementPrior Authorization ProcessingData Entry AccuracyClient Support ExperienceProblem-Solving Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims AdjudicationData CollectionConfiguration ValidationReport CreationEligibility Corrections

Soft Skills

Attention To DetailWritten CommunicationVerbal CommunicationTime ManagementCross-Functional Collaboration

Tools & Technologies

SpreadsheetsBasic Reporting ToolsOffice Equipment

Industry Keywords

PBM OperationsHealth Plan AdministrationClient Support RolePrior AuthorizationClaims Processing

About the role

Key responsibilities & impact

Manage texts, service emails, incoming calls, and voicemail
Serve as an escalation point for Helpdesk issues and resolve calls and questions not handled by Helpdesk agents
Maintain and update Helpdesk instructions and protocols
Respond to prior authorization status inquiries from providers and partner vendors
Resolve member coverage, cost, card, and prior authorization clinical criteria inquiries
Print and mail prior authorization denial letters
Assist members with portal registration and claims viewing for dependents
Enter rejection overrides and assist pharmacies with claim adjudication
Review and triage prior authorization tickets, remove duplicates, and archive inactive or aged tickets
Update provider fax information and resend prior authorization forms or decision faxes
Coordinate data collection for new accounts and renewals
Prepare implementation, plan change, legal, account structure, and drug/product list documents
Run claims testing to validate configuration accuracy
Attend weekly client meetings and track open issues
Maintain portal access, invoice, report, and rebate recipient records
Conduct portal tutorials and resolve report discrepancies
Create client-facing lists and collateral with the Marketing team
Provide census files and member contact information to partners and vendors
Send prior authorization approval and rejection summaries to partners and vendors
Notify clients and agents of formulary changes and member impacts
Review invoices, complete clinical reports, and create custom reports
Review reimbursement requests and disputed claims for eligibility and programming accuracy
Investigate accumulator discrepancies and eligibility file issues
Submit eligibility corrections and refund reports to the appropriate teams

Requirements

What you’ll need

Prior experience in pharmacy benefits, PBM operations, health plan administration, or a related account/client support role preferred
Strong attention to detail and accuracy, particularly with data entry, claims, and configuration work
Excellent written and verbal communication skills
Ability to manage multiple queues, tickets, and deadlines simultaneously
Comfort working with spreadsheets, data files, and basic reporting tools
Strong problem-solving skills and ability to research and resolve discrepancies independently
Ability to collaborate cross-functionally with internal teams
Largely sedentary role; ability to perform some standing, walking, bending, and reaching
Ability to operate a computer, mouse, keyboard, printer, copier, phone, and other standard office equipment

Benefits

Comp & perks

Remote-first team
Supportive culture encouraging employees to bring their whole self to work
Opportunities to grow alongside colleagues
Minimal travel may be required