Blue Cross Blue Shield Of Tennessee

Clinical Pharmacy Specialist

Blue Cross Blue Shield Of Tennessee • $80K — $95K *
Chattanooga, TN 37421In-Person
Healthcare
Less than 5 years of experience
Today
Be an Early Applicant
Job Overview by Ladders

Qualifications

  • High School Diploma or equivalent required
  • 2 years of pharmacy experience mandatory
  • National Certification as Pharmacy Technician (PTCB) required
  • Proficient in Microsoft Office applications
  • Excellent oral and written communication skills
  • Strong interpersonal and organizational capabilities
  • Proven decision-making and problem-solving abilities
  • Knowledge of medical/pharmacy terminology essential

Responsibilities

  • Enter authorizations and test claims into the pharmacy benefit system
  • Handle phone calls from providers and members for coverage determinations
  • Monitor and respond to emails and inquiries about pharmacy reviews
  • Review pharmacy reports for accurate claims processing
  • Assist with departmental audits and quality improvement initiatives
  • Work evenings, holidays, and weekends as needed for coverage

Benefits

  • Opportunities for skill development and certifications
  • Team-oriented work environment
  • Supportive company culture
  • Access to internal resources and tools for efficiency
  • Flexible scheduling with opportunities for on-call rotation
Full Job Description

Note:
  • Schedule: Monday-Friday 8AM-6PM EST, must be available to work nights and weekends on a rotating basis

Job Responsibilities
  • Enter authorizations and test claims into the pharmacy benefit system to ensure appropriate claim adjudication.
  • Handle incoming and outgoing phone calls from providers and/or members/members representatives to assist in completing coverage determinations and appeals.
  • Monitor and answer emails and FACETs inquiries from internal customers regarding pharmacy reviews, appeals, claims issues, etc.
  • Review daily pharmacy reports to ensure appropriate claims processing.
  • Assist with departmental audits and quality improvement activities.
  • May be required to work evenings, holidays and weekends to ensure adequate coverage to meet the business needs including on call rotations


Job Qualifications

Education
  • High School Diploma or equivalent


Experience
  • 2 years - Pharmacy experience required


Skills/Certifications
  • National Certification as Pharmacy Technician (PTCB)
  • Proficient in Microsoft Office (Outlook, Word, Excel and PowerPoint)
  • Must be a team player, be organized and have the ability to handle multiple projects
  • Excellent oral and written communication skills
  • Strong interpersonal and organizational skills
  • Proven decision making and problem solving skills
  • Ability to work independently and with minimal supervision
  • Knowledge in Medical/Pharmacy terminology


Number of Openings Available
1

Worker Type:
Employee

Company:
BCBST BlueCross BlueShield of Tennessee, Inc.

About Blue Cross Blue Shield Of Tennessee

BlueCross BlueShield of Tennessee is a non-profit health insurance company that provides coverage to more than 3.5 million people. The company was founded in 1945 and is headquartered in Chattanooga, Tennessee. BlueCross BlueShield of Tennessee offers a variety of health insurance plans, including individual and family plans, Medicare plans, and employer-sponsored plans. The company is committed to improving the health and well-being of its members and the communities it serves.
Learn more about Blue Cross Blue Shield Of Tennessee
Size
5,000 employees
Industry
Healthcare
Founded
1945
* Ladders Estimates

Similar Jobs

Ad banner background

Get Ready For Your
Next Interview

More Jobs at Blue Cross Blue Shield Of Tennessee

More Healthcare Jobs

Find similar Clinical Pharmacy Specialist jobs:

NationwideChattanooga, TN