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[Hiring] Representative I - Prior Authorizations @CVS Health

Work from home Full-time role Hiring

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.

  • Proficiency in pronouncing drug names and diagnoses.
  • Recognizing medical terminology.
  • Navigating multiple software systems to document conversations and outcomes.
  • Schedule flexibility including rotations through nights, weekends, and holiday coverage.

Qualifications

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

Requirements

  • Previous experience in pharmacy or healthcare industry (preferred).
  • Associate's or Bachelor's Degree (preferred).
  • Pharmacy Technician License (preferred).
  • Verifiable High School Diploma or equivalent GED.

Benefits

  • Medical, dental, and vision coverage.
  • Paid time off.
  • Retirement savings options.
  • Wellness programs.
  • Other resources, based on eligibility.

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