Remote Prior Authorization Specialist

7505 Caremark, L.L.C.; Louisiana (MO); Hybrid; USD 35,000 - 53,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Paid time off

Retirement savings plan

Wellness programs

Job summary

CVS Health is hiring a Representative I to be the first point of contact for Prior Authorization requests from members, providers, and a diverse customer base. You will determine if complex requests should be escalated to a pharmacist and maintain detailed documentation of approvals and denials.

The role requires schedule flexibility, including nights, weekends, and holidays, with a work-from-home option and reliable high-speed internet.

Qualifications

• 1 year of customer service or call center experience.
• Ability to work from home with reliable connectivity.
• Proficiency in pronouncing drug names and medical terminology.

Responsibilities

• Serve as the first contact for Prior Authorization requests.
• Determine when complex cases should be escalated to a pharmacist.
• Maintain complete, timely, and accurate documentation of approvals and denials.

Skills

Customer service

Remote work

High-speed internet

Education

High School Diploma or GED

Pharmacy Technician License

Job description

CVS Health is hiring a Representative I to be the first point of contact for Prior Authorization requests from members, providers, and a diverse customer base. You will determine if complex requests should be escalated to a pharmacist and maintain detailed documentation of approvals and denials.

The role requires schedule flexibility, including nights, weekends, and holidays, with a work-from-home option and reliable high-speed internet.