Remote Prior Authorization Specialist

CVS Health Corporation; Louisiana, Northern (MO, KY); Hybrid; USD 2,342,000 - 3,582,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health Corporation is seeking a Prior Authorization Representative to work from home in the United States. This role handles initial contact for authorization requests, determines when to escalate to a pharmacist, and ensures precise documentation of approvals and denials.

Flexibility for night, weekend, and holiday coverage is required. Candidates should have customer service experience, be able to work remotely with reliable internet, and ideally possess pharmacy/healthcare exposure and a

Qualifications

• 1 year experience in customer service or call center environment.
• Must be able to work from home.
• Have high speed internet.

Responsibilities

• Serve as first point of contact for Prior Authorization requests from members, providers and a diverse customer base.
• Determine if a complex request should be transferred to a pharmacist for assistance.
• Maintain complete, timely, and accurate documentation of approvals and denials.
• Navigate multiple software systems to document conversations and outcomes.

Skills

1 year experience in customer service

Work from home

High speed internet

Education

High School Diploma or GED

Associate's or Bachelor's Degree

Job description

CVS Health Corporation is seeking a Prior Authorization Representative to work from home in the United States. This role handles initial contact for authorization requests, determines when to escalate to a pharmacist, and ensures precise documentation of approvals and denials.

Flexibility for night, weekend, and holiday coverage is required. Candidates should have customer service experience, be able to work remotely with reliable internet, and ideally possess pharmacy/healthcare exposure and a