Provider Service Specialist

AP MAX INC•Houston, TX

22h

About The Position

We are seeking a detail-oriented Provider Service Specialist to support safe, compliant, and timely prescription processing within a compounding pharmacy environment. This role is responsible for verifying prescriber licensure, credentials, and regulatory eligibility; reviewing prescriptions prior to production; and ensuring compliance with federal and state laws, including controlled substance and telehealth prescribing requirements. The ideal candidate serves as a trusted compliance resource across pharmacy operations, intake, sales, and leadership teams.

Requirements

High school diploma or equivalent.
Minimum of 3 years of pharmacy technician experience in a regulatory, compliance, or specialty pharmacy environment (e.g., mail-order pharmacy, managed care, health informatics).
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.

Nice To Haves

Bachelor’s degree in Healthcare Administration, Health Sciences, Compliance, Business, or a related field.
Familiarity with provider credentialing and verification systems, including state license verification databases, ID.me, or MedPro.
Experience using provider operations platforms, such as CRM systems, telehealth compliance tools, or similar technologies used to support provider engagement and regulatory oversight.
Exposure to compliance and documentation systems, including Simplifi 797, DocuSign, or comparable platforms supporting sterile compounding documentation and digital workflow management.
Familiarity with pharmacy audit software, quality tracking platforms, or compliance monitoring tools.
Knowledge of DEA registration requirements, state prescribing authority rules, and exclusion monitoring (OIG/GSA).

Responsibilities

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.