Prior Authorization Representative
Job Description:
- Serve as the initial point of contact for Prior Authorization requests from members, providers, and a diverse customer base
- Determine whether complex requests should be transferred to a pharmacist for assistance
- Maintain complete, timely, and accurate documentation of approvals and denials
- Document conversations and outcomes across multiple software systems
Requirements:
- 1 year experience in customer service or call center environment
- Must be able to work from home
- High-speed internet
- Proficiency pronouncing drug names and diagnoses
- Ability to recognize medical terminology
- Ability to navigate multiple software systems
- Keyboarding skills
- Schedule flexibility, including rotations through nights, weekends, and holidays
- High School Diploma or equivalent GED
Benefits:
- Medical coverage
- Dental coverage
- Vision coverage
- Paid time off
- Retirement savings options
- Wellness programs
- Other resources supporting physical, emotional, and financial well-being
- CVS Health bonus, commission or short-term incentive program (eligible in addition to base pay)