Prior Authorization Technician I – Health Operations

CVS Health Corporation; Maine; Hybrid; USD 23,000 - 47,000; Full time

Benefits offered by this job

Medical insurance

Dental coverage

Vision coverage

Paid time off

Retirement plan

Wellness programs

Bonus eligibility

Job summary

CVS Health Corporation is seeking a Technician I, Prior Authorizations to handle inbound calls from providers, pharmacies, and members, and to document reviews accurately. You will transfer clinical questions to the pharmacist team and assist with fax and ePA processing, as well as outbound calls and mailbox inquiries.

The role requires basic MS Office skills and the ability to multitask across systems, with attention to confidentiality of PHI and strong communication abilities.

Qualifications

• Basic pharmaceutical terminology and protocols.
• Ability to use multiple system applications concurrently.
• Excellent written and verbal communication skills.
• Maintain confidentiality of PHI.
• Absorb information, stay motivated and solve problems.
• Adapt to changing workflow and priorities.

Responsibilities

• Handle inbound calls from providers, pharmacies and members.
• Maintain complete, timely documentation of reviews.
• Escalate to the pharmacist team as needed.
• Assist with outbound calls and processing Prior Auths via fax and ePA.
• Monitor inquiries via department mailboxes and other duties.

Skills

Multitasking

Written communication

Verbal communication

Problem solving

Teamwork

Education

High School Diploma or GED

Associate or Bachelor's degree preferred

Tools

Microsoft Excel

Microsoft Word

Outlook

PowerPoint

Access

Visio

Job description

CVS Health Corporation is seeking a Technician I, Prior Authorizations to handle inbound calls from providers, pharmacies, and members, and to document reviews accurately. You will transfer clinical questions to the pharmacist team and assist with fax and ePA processing, as well as outbound calls and mailbox inquiries.

The role requires basic MS Office skills and the ability to multitask across systems, with attention to confidentiality of PHI and strong communication abilities.