Pharmacy Authorization Technician | PBM & Quality (Hybrid)

Southcarolinablues; Columbia (SC); On-site; USD 25,000 - 33,000; Full time

Benefits offered by this job

Subsidized health plans

Dental and vision coverage

401k retirement savings plan with 회사 매

Life Insurance

PTO

On-site cafeterias

Education Assistance

Service Recognition

National discounts

Job summary

BlueCross BlueShield of South Carolina is seeking a Pharmacy Technician to set up and review pharmacy authorization requests, maintaining timely and accurate processing. You will interact with providers, members and PBM staff to resolve issues and document determinations under established guidelines.

Responsibilities include reviewing requests, loading determinations into systems, and escalating complex cases to pharmacists. Hybrid work option after training; located in Columbia, SC.

Qualifications

• High School Diploma or equivalent.
• 3 years pharmacy technician experience.
• Working knowledge of pharmaceutical claims, language, drug usage and generic substitution practices.
• Good judgment; demonstrated customer service and organizational skills.
• Proficiency in spelling, punctuation, and grammar skills.
• Analytical or critical thinking skills.
• Ability to handle confidential information with discretion.
• Attention to detail and the ability to handle multiple demands and priorities in a fast-paced environment.
• Ability to operate a computer.
• Microsoft Office experience.

Responsibilities

• Receives and builds cases for pharmacy authorization requests.
• Reviews, evaluates and authorizes approval of requests under pharmacist guidance.
• Requests additional information from providers including confidential medical history and prior drug therapy.
• Determines appropriateness for medications.
• Processes determination letters and communicates decisions to providers and members.
• Researches, resolves and documents outcomes in pharmacy system.
• Communicates selected authorization criteria, pharmacy benefit coverage, formulary alternatives and/or policies to providers, members and internal contacts.
• Loads authorization into the system and ensures documentation is accurate.
• Escalates complex requests to Pharmacist when needed.
• Participates in quality control and quality improvement activities.

Skills

Pharmacy claims knowledge

Customer service

Organizational skills

Spelling & grammar

Analytical thinking

Discretion with sensitive info

Attention to detail

Multitasking

Computer operation

Education

High School Diploma or equivalent

Registered Pharmacy Technician

Certified Pharmacy Technician

Tools

Microsoft Office

Job description

BlueCross BlueShield of South Carolina is seeking a Pharmacy Technician to set up and review pharmacy authorization requests, maintaining timely and accurate processing. You will interact with providers, members and PBM staff to resolve issues and document determinations under established guidelines.

Responsibilities include reviewing requests, loading determinations into systems, and escalating complex cases to pharmacists. Hybrid work option after training; located in Columbia, SC.