Job Description
Insight Global is seeking a Pharmacy Benefits Specialist to support a pharmacy operations team by ensuring proper authorizations are in place and helping to calculate patient out-of-pocket costs prior to medication dispensing. This person will work cross-functionally with both pharmacy and financial services partners to keep patient cases moving, support clean billing, and assist with payer audits and operational needs as required.
Day-to-Day Responsibilities
-Verify active and billable insurance coverage using Waystar (or similar platforms) and internal systems/resources.
-Assist the pharmacy site team with processing/shipping workflows when applicable. (starting out will be 70% pharm tech role including medication/supply fulfillment, labeling, organization, and outbound shipping for infusion therapies // 30% benefit verification)
-Confirm that current and viable authorizations are on file for all billable products and services prior to dispensing.
-Calculate and communicate patient out-of-pocket responsibility prior to medication fulfillment/shipment.
-Proactively communicate status updates and issues to appropriate departments to determine when to proceed or escalate.
-Support completion of external payor audits by gathering required data and documentation as needed.
-Maintain patient privacy and confidentiality and ensure work aligns with regulatory requirements and internal policies.
-Complete assigned documentation accurately and on time; contribute to a team-first environment by sharing knowledge and supporting peers.
We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.
Required Skills & Experience
• Reliability & professionalism — shows up on time and takes ownership of work
• Active Maryland Pharmacy Technician license (open to obtaining additional state licenses if needed)
• Experience verifying active and billable insurance coverage using Waystar or similar platforms
• High school diploma or GED
• Comfortable using Microsoft Suite (Outlook, Excel, basic systems)
• Self-starter that is detail oriented with strong time management skills
• Personable and professional on patient phone calls
Nice to Have Skills & Experience
• Previous specialty or infusion pharmacy experience
• Prior experience supporting prior authorizations, benefits verification, or billing-related workflows.
• Pharmacy Technician certification (PTCB or NPTA)
Benefit packages for this role will start on the 1st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.