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BlueCross BlueShield of South Carolina

Health insurance and plan administration

Pharmacy Technician

Full-TimeUpdated Deadline 11/9/26
No salary listed
Mid
Columbia, SC, USA
HybridHybrid work is available after the training period; the role is based at the Columbia office, with rotating weekend and holiday shifts.
Medical, Clinical & VeterinaryPharmacy

About the job

Requirements
  • High school diploma or equivalent.
  • Three years of pharmacy technician experience.
  • Working knowledge of pharmaceutical claims, pharmaceutical language, drug usage, and generic substitution practices.
  • Good judgment, customer service skills, and organizational skills.
  • Demonstrated proficiency in spelling, punctuation, and grammar.
  • Analytical or critical-thinking skills.
  • Ability to handle confidential or sensitive information with discretion.
  • Attention to detail and ability to handle multiple demands and priorities in a fast-paced environment.
  • Ability to remain stationary and operate a computer.
  • Working knowledge of Microsoft Office.
  • Registration as a Pharmacy Technician with the applicable state Board of Pharmacy and Certified Pharmacy Technician certification.
Responsibilities
  • Receive and build cases in applications for pharmacy authorization requests.
  • Under pharmacist guidance and company policies, guidelines, and established criteria, review, evaluate, and authorize pharmacy request approvals.
  • Request additional information from providers, including confidential medical history and prior drug therapy, to evaluate requests and determine medication appropriateness.
  • Process determination letters and communicate decisions to providers or members accurately and on time.
  • Research, resolve, and document outcomes in the pharmacy system.
  • Communicate authorization criteria, pharmacy benefit coverage, formulary alternatives, and Pharmacy Management program policies and procedures to pharmacy providers, members, and internal contacts.
  • Conduct research to establish a thorough and accurate basis for each determination.
  • Load authorizations into the system and ensure clinical determinations are documented accurately for all levels of care.
  • Use allocated resources to back up review determinations and complete assigned work within established timeliness guidelines.
  • Refer matters to appropriate staff, including pharmacists, case managers, preventive services, subrogation, and quality-of-care referral staff.
  • Escalate requests to a pharmacist when extensive clinical review is required.
  • Establish and maintain effective relationships with providers, members, and internal contacts; respond to inquiries and research and resolve issues using appropriate reference materials.
  • Participate in quality control and quality improvement activities supporting corporate and team objectives.
  • Participate in required licenses and certificates.
Desired Qualifications
  • Three years of pharmacy experience in a managed care setting or with a Pharmacy Benefit Manager.

About the company

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BlueCross BlueShield of South Carolina

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BlueCross BlueShield of South Carolina is a South Carolina-owned mutual health insurer and health-plan administrator. It offers individual, employer, Medicare and other coverage while operating provider networks, member services, claims and administrative programs. The organization also supports government and commercial health contracts through related businesses and specialized operations. This profile refers specifically to the South Carolina company, not the national Blue Cross Blue Shield Association, and centers on its role connecting members, employers, healthcare providers and public programs.

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