Prior Authorization Support Specialist

NHSHP; Worcester, Northern (MA, KY); Hybrid; USD 23,000 - 47,000; Full time

Job summary

CVS Health is hiring a Technician I, Prior Authorizations to handle inbound calls from providers, pharmacies and members, applying criteria-based review and documenting findings.

You will transfer complex questions to the pharmacist team, assist with outbound calls and process Prior Authorizations via fax and ePA.

This full-time position comes with a comprehensive benefits package and a chance to contribute to safer, more efficient patient care.

Qualifications

• Basic computer skills with proficiency in Microsoft Excel and Word.
• Ability to multitask and use multiple systems simultaneously.
• Knowledge of pharmaceutical terminology and prior authorization concepts.
• Excellent written and verbal communication with attention to privacy (PHI).

Responsibilities

• Handle inbound calls from providers, pharmacies and members for prior authorizations.
• Document reviews accurately and timely in the system.
• Escalate complex cases to pharmacists and transfer inquiries as needed.
• Assist with outbound calls and processing faxed or ePA Prior Auth requests.

Skills

MS Office

Excel

Word

Outlook

PowerPoint

Visio

Multitasking

PHI confidentiality

Strong communication

Pharmaceutical terminology

Education

High School Diploma or GED

Tools

Access

Outlook

PowerPoint

Visio

Excel

Word

Job description

CVS Health is hiring a Technician I, Prior Authorizations to handle inbound calls from providers, pharmacies and members, applying criteria-based review and documenting findings.

You will transfer complex questions to the pharmacist team, assist with outbound calls and process Prior Authorizations via fax and ePA.

This full-time position comes with a comprehensive benefits package and a chance to contribute to safer, more efficient patient care.