Prior Authorization Representative

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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)
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