Prior Authorization Representative (Work from Home)

CVS Health Corporation; Louisiana, Northern (MO, KY); Hybrid; USD 2,342,000 - 3,582,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health Corporation is seeking a Prior Authorization Representative to work from home in the United States. This role handles initial contact for authorization requests, determines when to escalate to a pharmacist, and ensures precise documentation of approvals and denials.

Flexibility for night, weekend, and holiday coverage is required. Candidates should have customer service experience, be able to work remotely with reliable internet, and ideally possess pharmacy/healthcare exposure and a

Qualifications

• 1 year experience in customer service or call center environment.
• Must be able to work from home.
• Have high speed internet.

Responsibilities

• Serve as first point of contact for Prior Authorization requests from members, providers and a diverse customer base.
• Determine if a complex request should be transferred to a pharmacist for assistance.
• Maintain complete, timely, and accurate documentation of approvals and denials.
• Navigate multiple software systems to document conversations and outcomes.

Skills

1 year experience in customer service

Work from home

High speed internet

Education

High School Diploma or GED

Associate's or Bachelor's Degree

Job description

## Prior Authorization Representative (Work from Home)Apply: Remote: LA - Work from home: Full time: Posted Today: End Date: October 30, 2026 (30+ days left to apply): R1044101We’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.**Job Summary** The Representative I is the initial point of contact for Prior Authorization requests from members, providers, and a diverse customer base. The Rep I will make the determination if a complex request should be transferred to a pharmacist for assistance. Additionally, the Rep I is responsible for maintaining complete, timely, and accurate documentation of all approvals and denials.In order to be successful in this role you will need proficiency pronouncing drug names and diagnosis and recognizing medical terminology. As well as navigating multiple software systems to document conversations and outcomes, which require keyboarding skills. This position requires schedule flexibility including rotations through nights, weekend and holiday coverage. **Required Qualifications** - 1 year experience in customer service or call center environment- Must be able to work from home- Have high speed internet **Preferred Qualifications** - Previous experience in pharmacy or healthcare industry.- Associate's or Bachelor's Degree. Pharmacy Technician License **Education** High School Diploma or equivalent GED**Anticipated Weekly Hours**40**Time Type**Full time**Pay Range**The typical pay range for this role is:$17.00 - $25.65This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.**Great benefits for great people**We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.This full‐time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‐being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.Additional details about available benefits are provided during the application process and on Benefits Moments.We anticipate the application window for this opening will close on: 10/30/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.