Remote Prior Authorization Specialist I

CVS Health; Georgia; Hybrid; USD 48,712,000 - 73,498,000; 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 in the United States is seeking a Tech I Prior Auth associate to take inbound calls from providers, pharmacies, and members, delivering professional assistance through the prior authorization process and ensuring complete documentation.

You will support outbound calls, process fax/ePA requests, and coordinate with pharmacists and leadership, while meeting confidentiality standards and adapting to workflow in a fast-paced environment.

Qualifications

• 6 months of Customer Service/Pharmacy Technician Experience
• Regular and predictable attendance
• Overtime/extended work week when needed
• Ability to travel when needed
• Handle inbound calls/fax requests with professional behavior
• Comply with regulations when processing information

Responsibilities

• Handle inbound calls/fax/ePA requests with professional behavior according to standards (40%)
• Ensure accuracy of information and documentation for internal/external customers (40%)
• Communicate with internal groups about determination status and results (10%)
• Identify and escalate clinical inquiries to pharmacists (5%)
• Perform other duties such as faxes, sorting, email boxes, CAS maintenance (5%)

Education

High School Diploma or GED

Tools

Microsoft Office Suite

Excel

Word

Access

Outlook

PowerPoint

Visio

Job description

CVS Health in the United States is seeking a Tech I Prior Auth associate to take inbound calls from providers, pharmacies, and members, delivering professional assistance through the prior authorization process and ensuring complete documentation.

You will support outbound calls, process fax/ePA requests, and coordinate with pharmacists and leadership, while meeting confidentiality standards and adapting to workflow in a fast-paced environment.