Associate Provider Relations Specialist

Insight Global; United States; On-site; USD 42,000 - 65,000; Full time

Job summary

Insight Global is seeking a detail-oriented professional to conduct outreach to pharmacies and handle claims-related inquiries. You will manage extension requests, process reversals, and triage emails to support regulatory and client commitments.

The role requires strong customer service, organizational skills, and proficiency with Microsoft Office. Experience in PBM or pharmacy settings is preferred, and United States work authorization is required.

Qualifications

• Bachelor’s degree in Business or related area or equivalent education/experience.
• 1+ year of experience in a call center, customer service, operations, retail pharmacy, or PBM.
• Eligibility to work in the United States without sponsorship.

Responsibilities

• Conduct outreach to participating pharmacies and provide timely information.
• Manage claims processing extension requests and triage inquiries via email.
• Research and resolve claims and conduct outreach to support regulatory and client commitments.
• Process claims reversals and identify process improvements.
• Prepare outreach reporting for stakeholders and update transaction controls as needed.
• Perform other duties as assigned.

Skills

Customer service

Communication

Problem solving

Time management

Attention to detail

Education

Bachelor’s degree in Business or related field

High school diploma or GED

Tools

Outlook

Word

Excel

Job description

Conduct outreach to participating pharmacies, provide accurate and timely information, manage claims processing extension requests, and triage inquiries received through the Pharmacy Provider Relations email box.

Responsibilities

• Research and resolve claims and conduct pharmacy outreach to support regulatory and client commitments and other initiatives.
• Research and elevate inquiries received through the Pharmacy Provider Relations email box.
• Process claims reversals.
• Identify and participate in department-level process improvements.
• Prepare pharmacy outreach reporting for internal and external stakeholders.
• Manage and resolve requests to update the transaction control table to extend timely filing.
• Other duties as assigned.

Minimum Qualifications

• Bachelor’s degree in Business or a related area, or equivalent education and relevant work experience. High school diploma or GED required.
• 1+ year of experience in a call center, customer service, operations, retail pharmacy, pharmacy technician, or Pharmacy Benefit Management (PBM).
• Must be eligible to work in the United States without work visa or residency sponsorship.

Additional Qualifications

• Demonstrated ability to solve complex issues in a timely manner.
• Strong customer service and collaboration skills.
• Strong organizational skills with the ability to manage multiple tasks simultaneously.
• Ability to work with confidential data and maintain privacy.
• Ability to evaluate and interpret policies and procedures.
• Ability to work in a fast-paced, collaborative team environment.
• Advanced proficiency with Microsoft Outlook, Word, and Excel.

Preferred Qualifications

• Experience working with RxClaim or other claims processing systems.
• Pharmacy Technician certification (CPhT) or equivalent pharmacy experience.