Prior Authorization Technician I — Healthcare Support

7505 Caremark, L.L.C.; Town of Texas (WI); Hybrid; USD 35,000 - 59,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking a Technician I, Prior Authorization to handle inbound calls from providers, pharmacies and members, providing courteous support through the criteria-based prior authorization process. You will document reviews, escalate to pharmacists, and assist with outbound calls and processing of Prior Auths.

The role emphasizes accuracy, confidentiality of PHI, multi-system navigation, and responsiveness to changing workflows. A full-time schedule with competitive benefits is offered.

Qualifications

• Basic computer skills and Microsoft Office proficiency required.
• Knowledge of Excel and Word required; Access/Outlook/PowerPoint/Visio preferable.
• Must multitask and use multiple systems independently to deliver high quality work.
• Pharmaceutical terminology, calculations and protocols familiarity.
• Ability to maintain confidentiality of PHI and communicate clearly.

Responsibilities

• Take inbound calls from providers, pharmacies, members and others with professional assistance.
• Document reviews completely and accurately; transfer clinical questions to the pharmacist team.
• Assist with outbound calls, processing Prior Auths, and monitoring inquiries via mailboxes.
• Support leadership with additional duties as assigned.

Skills

Basic computer skills

Microsoft Office Suite

Keyboard skills

Multitasking

Pharmaceutical knowledge

Confidentiality

Strong communication

Adaptability

Education

High School Diploma or GED

Tools

Microsoft Excel

Microsoft Word

Access

Outlook

PowerPoint

Visio

Job description

CVS Health is seeking a Technician I, Prior Authorization to handle inbound calls from providers, pharmacies and members, providing courteous support through the criteria-based prior authorization process. You will document reviews, escalate to pharmacists, and assist with outbound calls and processing of Prior Auths.

The role emphasizes accuracy, confidentiality of PHI, multi-system navigation, and responsiveness to changing workflows. A full-time schedule with competitive benefits is offered.