[Hiring] Prior Authorization Representative @CVS Health

Role Description

The Prior Authorization Representative is the initial point of contact for Prior Authorization requests from members, providers, and a diverse customer base. The Rep will make the determination if a complex request should be transferred to a pharmacist for assistance. Additionally, the Rep is responsible for maintaining complete, timely, and accurate documentation of all approvals and denials.

• Proficiency in pronouncing drug names and diagnoses
• Recognizing medical terminology
• Navigating multiple software systems to document conversations and outcomes
• Schedule flexibility including rotations through nights, weekends, and holiday coverage

Qualifications

• 1+ years' experience in customer service or call center environment
• Must be able to work from home
• Have high-speed internet

Requirements

• Previous experience in pharmacy or healthcare industry (preferred)
• Associate's or Bachelor's Degree (preferred)
• Pharmacy Technician License (preferred)
• High School Diploma or equivalent GED

Benefits

• Medical, dental, and vision coverage
• Paid time off
• Retirement savings options
• Wellness programs
• Other resources, based on eligibility

Company Description

We’re building a world of health around every individual — shaping a more connected, convenient, and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable, and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family, and one community at a time.