Prior Authorization Support Specialist - Tech I

CVS Health; California (MO); Hybrid; USD 48,712,000 - 89,687,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement plan

Wellness programs

Job summary

CVS Health is seeking a Tech I Prior Auth to manage inbound calls from providers, pharmacies, members, etc., guiding them through the prior authorization process. You will document reviews accurately and transfer clinical questions to the pharmacist team as needed.

The role includes processing Prior Auths via fax/ePA, outbound calls, and responding to inquiries while supporting leadership with a proactive, compliant approach.

Qualifications

• High School Diploma or GED (or equivalent).
• 6 months of Customer Service/Pharmacy Technician experience.
• Regular and predictable attendance; overtime and travel as needed.
• Maintain confidentiality of PHI (Protected Health Information).
• Able to absorb information, stay motivated, and problem-solve.

Responsibilities

• Handle inbound calls, faxes, and ePA requests with courteous, professional behavior.
• Document reviews timely and accurately; ensure information accuracy.
• Escalate clinical questions to the pharmacist team as needed.
• Assist with outbound calls and processing of Prior Auths via fax and ePA.
• Coordinate with internal teams regarding determination status and results.

Skills

Customer service

Communication skills

Multitasking

Confidentiality

Education

High School Diploma

Tools

Microsoft Excel

Microsoft Word

Microsoft Outlook

PowerPoint

Visio

Job description

CVS Health is seeking a Tech I Prior Auth to manage inbound calls from providers, pharmacies, members, etc., guiding them through the prior authorization process. You will document reviews accurately and transfer clinical questions to the pharmacist team as needed.

The role includes processing Prior Auths via fax/ePA, outbound calls, and responding to inquiries while supporting leadership with a proactive, compliant approach.