Provider Service Specialist

Role Overview

• Verify prescriber licensure and credentials using approved state and federal databases.
• Review and validate prescription eligibility prior to release to production.
• Confirm prescribers are legally authorized and appropriately credentialed to prescribe medications offered by the pharmacy, including controlled substances, hormone therapies, and sterile preparations.
• Ensure prescriptions originate from legally authorized prescribers.
• Ensure prescribing habits match the provider's scope of practice.
• Prioritize verification activities to meet dispensing timelines.
• Provide real-time support to pharmacy technicians, pharmacists, intake staff, sales, and compliance teams regarding prescriber eligibility and regulatory restrictions.
• Identify high-risk, non-compliant, or potentially problematic prescribing activity and escalate concerns to compliance leadership.
• Assist sales and account management teams by clarifying prescriber compliance requirements.
• Stay current on evolving prescribing guidelines and regulatory updates.
• Monitor compliance with federal and state prescribing laws, including telemedicine and telehealth regulations.
• Confirm prescriber DEA registration status and controlled substance compliance (e.g., valid DEA numbers, prescription sequencing, patient exam requirements).
• Track state-specific prescribing privileges and regulatory requirements.
• Track license, registration, and credential expiration dates and follow up on renewals.
• Coordinate with prescribers and their staff to resolve discrepancies, obtain missing documentation, or update credentials.
• Maintain accurate digital and physical credentialing records including but not limited to pharmacy management systems and customer relationship management systems.
• Support data integrity initiatives by identifying inconsistencies or outdated information.
• Create, update, and maintain provider onboarding documentation.
• Prepare compliance reports for internal stakeholders.
• Serve as a trusted point of contact for compliance-related questions or concerns.

Requirements

• High school diploma or equivalent.
• Minimum of one (1) year of pharmacy technician experience and three (3) years of experience performing prescriber verification, including verifying prescriber licensure, credentials, DEA registration, and regulatory compliance within a pharmacy or healthcare environment.
• Active pharmacy technician license and national certification (PTCB or NHA).
• Strong working knowledge of federal and state pharmacy laws and regulations, including FDA, DEA, HIPAA, and applicable state boards of pharmacy (e.g., TSBP).
• Demonstrated experience verifying prescriber credentials, including state licensure, DEA registration, and prescribing authority.
• Proven ability to identify compliance risks, discrepancies, or regulatory deviations and recommend corrective actions.
• Experience using a Pharmacy Management System, such as LifeFile or a comparable pharmacy management platform.
• Intermediate proficiency in Microsoft Excel, including maintaining tracking logs, organizing data, and monitoring operational workflows.
• Ability to work across multiple digital platforms and systems while maintaining accuracy and compliance in provider service operations.
• Experience with provider credentialing, onboarding, or pharmacy operations.
• Exceptional attention to detail and documentation accuracy.
• Ability to work cross-functionally with compliance, legal, and pharmacy operations teams.
• Comfortable handling confidential, regulated, and sensitive information.

Benefits

• Comprehensive benefits package including medical, dental, paid time off, and a 401(k) retirement plan.