Remote Prior Authorization Specialist

CVS Health Corporation; United States; Remote; USD 23,000 - 34,000; Full time

Job summary

CVS Health is seeking a Representative I to be the first point of contact for Prior Authorization requests from members, providers, and a diverse customer base. You will assess and determine if a complex request should be escalated to a pharmacist for assistance.

You will maintain complete, timely, and accurate documentation of all approvals and denials, using multiple software systems as you support a patient-centered workflow. Schedule flexibility includes nights, weekends, and holidays.

Qualifications

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

Responsibilities

• Be the initial point of contact for Prior Authorization requests from members, providers, and diverse customers.
• 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; work with occasional night, weekend, and holiday shifts.

Skills

Customer service

Remote work

Education

High School Diploma or GED

Job description

CVS Health is seeking a Representative I to be the first point of contact for Prior Authorization requests from members, providers, and a diverse customer base. You will assess and determine if a complex request should be escalated to a pharmacist for assistance.

You will maintain complete, timely, and accurate documentation of all approvals and denials, using multiple software systems as you support a patient-centered workflow. Schedule flexibility includes nights, weekends, and holidays.