Prior Authorization Technician I — Healthcare Operations

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

Benefits offered by this job

Benefits package

Job summary

CVS Health Corporation is seeking a Technician I, Prior Authorizations to handle inbound calls from providers, pharmacies, members and other callers, guiding them through the criteria-based prior authorization process. You will document reviews accurately and transfer clinical questions to the pharmacist team.

The role includes supporting outbound calls and processing Prior Authorizations received via fax and ePA, with a focus on quality and timely responses in a fast-paced environment.

Qualifications

• Ability to apply basic computer skills and use MS Office applications.
• Capable of multitasking with multiple system applications.
• Basic pharmaceutical terminology and protocol knowledge.
• Able to maintain confidentiality of PHI and produce high-quality work.

Responsibilities

• Handle inbound calls from providers, pharmacies, and members for prior authorizations.
• Maintain complete and accurate documentation of reviews.
• Escalate clinical questions to the pharmacist team.
• Assist with outbound calls and processing prior auths received via fax or ePA.

Skills

Multitask

Pharmaceutical knowledge

Communication skills

Confidentiality (PHI)

Microsoft Office

Education

High School Diploma or GED

Tools

Excel

Word

Outlook

PowerPoint

Job description

CVS Health Corporation is seeking a Technician I, Prior Authorizations to handle inbound calls from providers, pharmacies, members and other callers, guiding them through the criteria-based prior authorization process. You will document reviews accurately and transfer clinical questions to the pharmacist team.

The role includes supporting outbound calls and processing Prior Authorizations received via fax and ePA, with a focus on quality and timely responses in a fast-paced environment.