Pharmacy Authorization Specialist (Hybrid)

BlueCross and BlueShield of South Carolina; Columbia (SC); Hybrid; USD 36,000 - 48,000; Full time

Job summary

BlueCross and BlueShield of South Carolina is seeking a detail‑oriented Pharmacy Authorization Clerk to set up cases and conduct reviews in a hybrid, fast‑paced office environment in Columbia, SC. You will interface with providers, members and the PBM to resolve issues and ensure timely processing of authorization requests.

The role requires a high school diploma, 3 years of pharmacy technician experience, and proficiency with Microsoft Office.

Qualifications

• Working knowledge of pharmaceutical claims, language, drug usage and generic substitution practices.
• Good judgment and strong customer service and organizational skills.
• Able to handle confidential or sensitive information with discretion.
• Strong spelling, punctuation and grammar.

Responsibilities

• Set up cases for pharmacy authorization requests and perform reviews per criteria.
• Process determination letters and document decisions per protocol.
• Interact with providers, members and PBM to resolve issues and ensure timely processing.
• Participate in quality control or quality improvement activities.

Skills

Pharmacy claims

Customer service

Attention to detail

Analytical thinking

Confidentiality

Computer skills

Education

High School Diploma or equivalent

Tools

Microsoft Office

Job description

BlueCross and BlueShield of South Carolina is seeking a detail‑oriented Pharmacy Authorization Clerk to set up cases and conduct reviews in a hybrid, fast‑paced office environment in Columbia, SC. You will interface with providers, members and the PBM to resolve issues and ensure timely processing of authorization requests.

The role requires a high school diploma, 3 years of pharmacy technician experience, and proficiency with Microsoft Office.