Summary
 

We are currently hiring for a Pharmacy Program Coordinator to join BlueCross BlueShield of South Carolina. In this role as Pharmacy Program Coordinator, you will perform customer service tasks by responding accurately to pharmacy claim and member inquiries related to drug benefits and membership. Review, investigate, and resolve problems within the pharmacy benefit and processing of claims through the pharmacies. Serve as central point of contact between pharmacy operations and account representatives for issue management and triaging. Assist with the training of new employees. Create and maintain procedure documents to be used by all team members.

Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we have been part of the national landscape, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina … and much more. We are one of the nation’s leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies that allows us to build on a variety of business strengths. We deliver outstanding service to our customers. If you are committed to the same philosophy, consider joining our team!

Here is your opportunity to join a dynamic team at a diverse company with secure, community roots and an innovative future.

Description
 

Logistics

This position is full time (40 hours/week) Monday-Friday 9:00-5:30 and will be W@H for South Carolina residents. (This position will occasionally be required to work the 11:30-8:00PM shift)

What You Will Do:

• Coordinates customer service and responds to pharmacy inquiries related to drug eligibility and drug benefits for the private business pharmacy plans. Reviews, investigates, and resolves problems within the pharmacy benefit and processing of claims through the pharmacies.
• Serves as liaison with the pharmacy benefit manager (PBM) and their account representatives. Serves as central point of contact between the PBM, operations, and account representatives.
• Coordinates and tests benefit changes or new benefit/drugs design scope codes. Coordinates plan design testing, system testing, and system updates on the pharmacy benefit management system.
• Processes and maintains daily, monthly, and quarterly reports containing analysis of pharmacy activity, eligibility, and processing of the pharmacy plan.
• Performs quality control audits on all aspects of pharmacy benefit files, payment structure, and policy exclusions.

To Qualify for This Position, You Will Need:

• High School Diploma or equivalent
• Two years of job related customer service and/or benefit claims experience.
• Required Skills and Abilities: Good judgment skills. Effective customer service and organizational skills. Demonstrated verbal and written communication skills. Demonstrated proficiency in spelling, punctuation, and grammar. Ability to handle confidential or sensitive information with discretion.
• Required Software and Tools: Microsoft Office.

What We Can Do for You:

• 401(k) retirement savings plan with company match.
• Subsidized health plans and free vision coverage.
• Life insurance.
• Paid annual leave – the longer you work here, the more you earn.
• Nine paid holidays.
• On-site cafeterias and fitness centers in major locations.
• Wellness programs and healthy lifestyle premiu