Technician I, Prior Authorizations - Operations

CVS Health Corporation; Maine; Hybrid; USD 23,000 - 47,000; Full time

Benefits offered by this job

Medical insurance

Dental coverage

Vision coverage

Paid time off

Retirement plan

Wellness programs

Bonus eligibility

Job summary

CVS Health Corporation is seeking a Technician I, Prior Authorizations to handle inbound calls from providers, pharmacies, and members, and to document reviews accurately. You will transfer clinical questions to the pharmacist team and assist with fax and ePA processing, as well as outbound calls and mailbox inquiries.

The role requires basic MS Office skills and the ability to multitask across systems, with attention to confidentiality of PHI and strong communication abilities.

Qualifications

• Basic pharmaceutical terminology and protocols.
• Ability to use multiple system applications concurrently.
• Excellent written and verbal communication skills.
• Maintain confidentiality of PHI.
• Absorb information, stay motivated and solve problems.
• Adapt to changing workflow and priorities.

Responsibilities

• Handle inbound calls from providers, pharmacies and members.
• Maintain complete, timely documentation of reviews.
• Escalate to the pharmacist team as needed.
• Assist with outbound calls and processing Prior Auths via fax and ePA.
• Monitor inquiries via department mailboxes and other duties.

Skills

Multitasking

Written communication

Verbal communication

Problem solving

Teamwork

Education

High School Diploma or GED

Associate or Bachelor's degree preferred

Tools

Microsoft Excel

Microsoft Word

Outlook

PowerPoint

Access

Visio

Job description

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Position Summary

The Technician I, Prior Authorizations takes in-bound calls from providers, pharmacies, members, etc providing professional and courteous phone assistance to all callers through the criteria based prior authorization process. Maintains complete, timely and accurate documentation of reviews. Transfers all clinical questions, escalations and judgement calls to the pharmacist team.

The Tech I will also assist with other duties as needed to include but not limited to: outbound calls, reviewing and processing Prior Auth’s received via fax and ePA, monitoring and responding to inquiries via department mailboxes and other duties as assigned by the leadership team.

Required Qualifications

• Able to apply basic computer skills. Knowledge of Microsoft Office Suite: Excel and Word required; Access, Outlook, PowerPoint, Visio preferable. Keyboard skills essential.
• Must be able to multitask and utilize multiple system applications simultaneously.
• Basic pharmaceutical knowledge pertaining to terminology, calculations, and protocols.
• Must be able to utilize available resources independently and provide high quality work.
• Must be able to absorb presented information, display motivation, seek development and problem solve.
• Ability to adapt and change with workflow and shifting priorities.
• Must possess excellent written, verbal, grammar, and listening communication skills.
• Must be able to deal with a diverse customer base (internal and external) in a friendly and confident manner.
• Ability to maintain confidentiality of PHI (Protected Healthcare Information).

Preferred Qulaifications

• Associate Degree or Bachelor’s Degree: If neither degree held, then equivalent years of work experience

Education

High School Diploma or equivalent GED

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$17.00 - $34.15

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments (https://learn.bswift.com/cvshealth-mainland) .

We anticipate the application window for this opening will close on: 10/02/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

CVS Health is an equal opportunity/affirmative action employer, including Disability/Protected Veteran — committed to diversity in the workplace.