Account Executive

Position Summary

The Account Executive is responsible for owning clinic account experience, managing prescription workflows, and providing daily operational support for ClaimBridge Health's Medically Integrated Dispensing (MID) services.

This individual contributor role requires strong operational expertise in clinic dispensing, specialty pharmacy, or healthcare account management. The position manages end-to-end prescription workflows, processes claims and prior authorizations, resolves clinic issues, supports onboarding and implementation of clinics, and contributes to the ongoing development and refinement of AI-supported workflows. Success in the role requires independent judgment, consistent process ownership, and the ability to deliver high-quality support while helping maintain scalable operational standards.

Essential Duties and Responsibilities

Prescription Workflow Management

• Own and manage the daily prescription workflow for assigned clinics, including intake, verification, processing, exception handling, and coordination through dispensing and fulfillment.
• Monitor workflow queues, identify bottlenecks or errors, and take proactive action to maintain timely, accurate, and compliant processing.
• Ensure complete and accurate documentation that supports both operational execution and continuous improvement of AI-enabled processes.
• Collaborate with clinic staff to resolve prescription-related issues and prevent recurrence.

Account Experience & Daily Communications

• Serve as the primary day-to-day point of contact for assigned clinic partners, delivering responsive, professional, and solution-oriented communication.
• Oversee overall account experience by proactively identifying service gaps, addressing concerns, and maintaining high clinic satisfaction and retention.
• Manage escalation of complex issues while keeping clinics informed of status and resolution timelines.
• Conduct regular check-ins and provide operational guidance to help clinics optimize their in-office dispensing processes.

Claims Processing & Prior Authorization Management

• Process and submit claims accurately and timely, including follow-up on denials, rejections, and reimbursement issues.
• Initiate, prepare, submit, and track Prior Authorizations, including gathering required clinical information, communicating with payers and clinics, and managing additional documentation or appeals.
• Maintain thorough, audit-ready records of claims and prior authorization activity.
• Identify recurring denial or authorization patterns and recommend operational or process improvements.

Clinic Onboarding & Implementation

• Lead or support onboarding and implementation of new clinic partners, including workflow setup, system training, process documentation, and go-live support.
• Develop and deliver training materials and sessions for clinic staff on ClaimBridge processes and tools.
• Ensure new clinics achieve operational readiness and a smooth transition into ongoing support.

AI Workflow Support & Process Improvement

• Document clinic and internal workflows to support ongoing training, refinement, and improvement of AI tools and automation.
• Provide subject-matter input, labeled examples, edge-case scenarios, and structured feedback to help improve AI accuracy and workflow efficiency.
• Identify opportunities to automate repetitive tasks, improve accuracy, and reduce manual effort.
• Test new AI features or workflow updates and provide feedback to relevant teams.

Additional Responsibilities

• Maintain accurate records, reports, and documentation consistent with compliance and audit requirements.
• Support adherence to applicable healthcare regulations, payer requirements, and internal policies.
• Contribute to the development and maintenance of standard operating procedures.
• Perform other duties as assigned to support clinic success and operational consistency.

Qualifications

Required

• High school diploma or GED.
• Minimum of 5 years of progressive experience in a prescriber office, specialty pharmacy, clinic dispensing, healthcare account management, or closely related operational role.
• Demonstrated experience managing prescription workflows, claims processing, or prior authorizations.
• Strong written and verbal communication skills with the ability to interact professionally with clinic staff, providers, and internal teams.
• Proven ability to work independently, manage multiple priorities, and meet deadlines in a remote environment.
• Proficiency with common healthcare systems, spreadsheets, and documentation tools.
• Ability to clearly document processes and contribute to workflow and AI tool refinement.

Preferred

• Experience with in-office or medically integrated dispensing programs.
• Familiarity with specialty pharmacy operations, payer portals, or electronic prior authorization tools.
• Experience supporting technology implementations, process improvement, or staff training.
• Knowledge of common specialty or clinic-dispensed therapeutic areas.

Key Competencies

• Operational Ownership: Takes full responsibility for assigned accounts and workflows with minimal supervision.
• Problem Solving & Issue Resolution: Diagnoses root causes and implements practical, lasting solutions.
• Communication & Relationship Management: Builds trust through clear, timely, and professional communication.
• Attention to Detail & Accuracy: Maintains high standards in claims, authorizations, and documentation.
• Adaptability & Learning Agility: Quickly learns new systems, processes, and workflow tools.
• Process Orientation: Documents workflows clearly and contributes to standardization and continuous improvement.
• Collaboration: Works effectively with clinic partners and cross-functional teams in a remote setting.

ClaimBridge Health is an equal opportunity employer.