Prior Authorization Tech I — Healthcare Operations

CVS Health Corporation; Wyoming (OH); Hybrid; USD 23,000 - 47,000; Full time

Benefits offered by this job

Comprehensive benefits package

Performance bonus

Paid time off

Job summary

CVS Health Corporation is seeking a Technician I, Prior Authorizations to handle inbound calls from providers, pharmacies, and members. You will document reviews, and transfer clinical questions to the pharmacist team to ensure accurate, timely decisions.

The role requires basic computer skills, proficiency with Microsoft Office, and the ability to multitask across multiple systems. A high school diploma is required, with further education preferred.

Qualifications

• Familiarity with Microsoft Office; ability to use Excel and Word.
• Ability to multitask and use multiple systems concurrently.
• Basic pharmaceutical terminology and dosage concepts.
• Discretion with PHI and data handling.

Responsibilities

• Handle inbound calls from providers, pharmacies and members for prior authorizations.
• Document reviews accurately and in a timely manner.
• Escalate clinical questions to pharmacists as needed.
• Support outbound calls and processing of fax/ePA authorizations.

Skills

Microsoft Office Suite

Multitask

PHI confidentiality

Effective communication

Customer service

Pharmaceutical terminology

Education

High School Diploma or GED

Associate or Bachelor preferred

Job description

CVS Health Corporation is seeking a Technician I, Prior Authorizations to handle inbound calls from providers, pharmacies, and members. You will document reviews, and transfer clinical questions to the pharmacist team to ensure accurate, timely decisions.

The role requires basic computer skills, proficiency with Microsoft Office, and the ability to multitask across multiple systems. A high school diploma is required, with further education preferred.