[Hiring] Representative I - Prior Authorizations @CVS Health
Role Description
The Representative I, Prior Authorizations is the initial point of contact for Prior Authorization requests from members, providers, and a diverse customer base. The Rep I will make the determination if a complex request should be transferred to a pharmacist for assistance. Additionally, the Rep I is responsible for maintaining complete, timely, and accurate documentation of all approvals and denials.
ā¢ Proficiency in pronouncing drug names and diagnoses.
ā¢ Recognizing medical terminology.
ā¢ Navigating multiple software systems to document conversations and outcomes.
ā¢ Schedule flexibility including rotations through nights, weekends, and holiday coverage.
Qualifications
ā¢ 1 plus years' experience in customer service or call center environment.
ā¢ Must be able to work from home.
ā¢ Have high-speed internet.
Requirements
ā¢ Previous experience in pharmacy or healthcare industry (preferred).
ā¢ Associate's or Bachelor's Degree (preferred).
ā¢ Pharmacy Technician License (preferred).
ā¢ Verifiable High School Diploma or equivalent GED.
Benefits
ā¢ Medical, dental, and vision coverage.
ā¢ Paid time off.
ā¢ Retirement savings options.
ā¢ Wellness programs.
ā¢ Other resources, based on eligibility.
Apply tot his job
Apply To this Job
The Representative I, Prior Authorizations is the initial point of contact for Prior Authorization requests from members, providers, and a diverse customer base. The Rep I will make the determination if a complex request should be transferred to a pharmacist for assistance. Additionally, the Rep I is responsible for maintaining complete, timely, and accurate documentation of all approvals and denials.
ā¢ Proficiency in pronouncing drug names and diagnoses.
ā¢ Recognizing medical terminology.
ā¢ Navigating multiple software systems to document conversations and outcomes.
ā¢ Schedule flexibility including rotations through nights, weekends, and holiday coverage.
Qualifications
ā¢ 1 plus years' experience in customer service or call center environment.
ā¢ Must be able to work from home.
ā¢ Have high-speed internet.
Requirements
ā¢ Previous experience in pharmacy or healthcare industry (preferred).
ā¢ Associate's or Bachelor's Degree (preferred).
ā¢ Pharmacy Technician License (preferred).
ā¢ Verifiable High School Diploma or equivalent GED.
Benefits
ā¢ Medical, dental, and vision coverage.
ā¢ Paid time off.
ā¢ Retirement savings options.
ā¢ Wellness programs.
ā¢ Other resources, based on eligibility.
Apply tot his job
Apply To this Job