Pharmacy Technician - Prior Authorization - Work From Home

CVS Health

3d • $17 - $28 • Remote

About The Position

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 Pharmacy Technician, Prior Authorization 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. Additional responsibilities to include but not limited to the following: Effectively manage work volume by handling inbound calls/fax/ePA requests utilizing appropriate courteous and professional behavior based upon established standards. Comply with departmental, company, state, and federal requirements when processing all information to ensure accuracy of information being provided to internal and external customers. Communication with other internal groups regarding determination status and results (seniors, pharmacists, appeals, etc). Identify and elevate clinical inquiries to the pharmacist team as appropriate. Other duties assigned, for example faxes, sorting, email boxes, CAS maintenance, etc.

Requirements

• Able to apply basic computer skills.
• Knowledge of Microsoft Office Suite: Excel and Word required; Access, Outlook, PowerPoint, Visio preferable.
• Keyboard skills essential.
• Basic pharmaceutical knowledge pertaining to terminology, calculations, and protocols.
• High School Diploma or equivalent GED

Nice To Haves

• Must be able to multitask and utilize multiple system applications simultaneously.
• 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).

Responsibilities

• Effectively manage work volume by handling inbound calls/fax/ePA requests utilizing appropriate courteous and professional behavior based upon established standards.
• Comply with departmental, company, state, and federal requirements when processing all information to ensure accuracy of information being provided to internal and external customers.
• Communication with other internal groups regarding determination status and results (seniors, pharmacists, appeals, etc).
• Identify and elevate clinical inquiries to the pharmacist team as appropriate.
• Other duties assigned, for example faxes, sorting, email boxes, CAS maintenance, etc.

Benefits

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
• For more information, visit https://jobs.cvshealth.com/us/en/benefits

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED