TrueScripts Management Services

Customer Support

• Account Inquiries & Claims Processing
• Assist TrueScripts' members with pharmacy claims processing and plan benefits
• Receive phone calls/emails from members, clients, pharmacies and/or physician offices
• Troubleshoot claim processing problems and/or inquiries in claims adjudication system
• Respond to website inquiries
• Become proficient in all aspects of claims adjudication system
• Communicate escalated member service concerns to manager
• Account Support QA testing for client transitions/changes
• Complete pharmacy contact sheet for fax notifications
• Claims Logging, Invoicing & Reporting
• Log Specialty Care, Brand Care, Paper Claims, and Fee for Prior Authorizations on SharePoint
• Log Specialty and Non-Specialty Prior Authorization approvals on SharePoint
• Prepare and send weekly/monthly invoices to the Accounting team
• Document actions and outcomes in the client database

Member Care Advocate, Customer Service Representative

Business Intelligence Analyst

• Prepare, analyze, and deliver reporting for client requests, standard client Rx review reports, new client repricing, Power BI dashboards, and quality audits.
• Build a deep understanding of PBM industry operations and client data environments.
• Leverage both business and technical skills to work effectively across Business Intelligence, CRM systems, and transactional claims data.
• Conduct thorough quality audits on all analyses and reports prior to department distribution.
• Partner with business process owners to recommend and implement continuous improvements.
• Analyze legacy PBM claims for accuracy and completeness.
• Prepare repricing analyses for broker review and support accurate claims ingestion into I.R.I.S. Analytics.
• Document and refine repricing processes to increase speed and consistency.
• Analyze Rx review reporting for accuracy and completeness.
• Provide clear analysis to help clients understand key cost drivers.
• Create polished summary reports and presentations in PowerPoint and/or Excel.
• Work closely with cross-functional teams to understand business requirements.
• Utilize Power BI to develop and maintain reporting and dashboards.
• Deliver reports in Excel, PDF, and PowerPoint formats, tailored to stakeholder needs.
• Utilize SQL Server to query, prepare, and analyze datasets within I.R.I.S. Analytics.

Reporting Analyst

Compliance

• Serve as a compliance thought partner to operational leaders by identifying regulatory risk, evaluating compliance gaps, and helping design practical, scalable solutions
• Monitor and interpret state and federal PBM legislation and regulations, translating requirements into clear guidance and action plans
• Oversee and support the operational implementation of new regulatory mandates across the organization
• Lead or support HIPAA and privacy investigations in partnership with legal and operational teams
• Manage and support regulatory reporting
• Coordinate NADAC and acquisition cost reimbursement compliance activities
• Develop and maintain compliance protocols, controls, and monitoring processes to support ongoing regulatory adherence
• Design and deliver compliance training and education that helps teams understand both the requirements and the rationale behind them
• Draft and distribute compliance alerts, regulatory updates, and internal guidance
• Respond to compliance-related RFP questions and client or regulatory inquiries, helping demonstrate TrueScripts’ compliance maturity
• Support Business Development and Client Services with compliance documentation and due diligence requests
• Manage and maintain state licensing requirements
• Conduct regulatory research and trend analysis to inform strategic planning and proactive compliance initiatives

Compliance Manager

Financial Planning and Analysis

• Assist in client invoicing including but not limited to client set-up, client account maintenance, client reporting requests and collections.
• Other responsibilities will include account reconciliation, commissions, and rebate assistance.
• Setup and maintain client accounts
• Prepare weekly and monthly invoices, detailed reports, and correspondence
• Update and maintain detailed work instructions on the invoicing process
• Maintain accurate client contacts
• Work with Client Success Team for all client onboarding activities
• Perform quality audits of client data
• Provide clients, TPAs, and brokers with requested reporting on a weekly or monthly basis
• Provide adhoc reports or supporting backup reports, as requested
• Payment application and reconciliation
• Coordinates collections of past due accounts
• Provide A/R reporting to brokers and management as needed
• Collaborate with outside clients and internal finance team to maintain accurate accounts receivable
• Monthly account reconciliation and analysis, including bank reconciliations for all cash accounts
• Calculate quarterly rebates
• Prepare backup, communication, and payments for client distribution
• Maintain monthly cash flow analysis and share with executive team monthly
• Update and determine monthly cash flow buckets
• ACH for vendor and client payments
• Perform other duties as assigned

Client Reporting and Billing Specialist – Finance/Accounting

Pricing Analyst

• Overseeing pricing governance, deal structuring, RFP responses, contracting, and approval processes for new and renewal PBM client contracts
• Serve as a strategic partner to Sales, Underwriting, Finance, Legal, and Clinical teams
• Ensure deals are financially sound, compliant, and aligned with company pricing and risk standards
• Lead the review, structuring, and approval of complex PBM client deals
• Ensure all deals comply with pricing policies, financial targets, regulatory requirements, and risk tolerance
• Evaluate financial impact of pricing components such as ingredient cost models, rebates, and performance guarantees
• Partner closely with Sales to provide pricing guidance and deal strategy support
• Collaborate with Underwriting and Finance to assess deal profitability and risk exposure
• Work with Legal and Compliance to ensure contract terms align with approved deal economics
• Manage the end-to-end deal desk workflow, including intake, review, approvals, and documentation
• Provide guidance and training to Sales and Account teams on pricing policies and deal mechanics
• Support executive leadership with deal analytics and summaries for high-value or high-risk opportunities

Member Care Advocate, Customer Service Representative

Reporting Analyst

Compliance Manager

Client Reporting and Billing Specialist – Finance/Accounting

Pricing Strategy Manager