Prior Authorization Representative (Work from Home)
About The Position
The Prior Authorization Representative 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. In order to be successful in this role you will need proficiency pronouncing drug names and diagnosis and recognizing medical terminology. As well as navigating multiple software systems to document conversations and outcomes, which require keyboarding skills. This position requires schedule flexibility including rotations through nights, weekend and holiday coverage.
Requirements
- 1+ years' experience in customer service or call center environment
- Must be able to work from home
- Have high-speed internet
- Proficiency pronouncing drug names and diagnosis and recognizing medical terminology
- Ability to navigate multiple software systems
- Keyboarding skills
Nice To Haves
- Previous experience in pharmacy or healthcare industry
- Associate's or Bachelor's Degree
- Pharmacy Technician License
Responsibilities
- Act as the initial point of contact for Prior Authorization requests from members, providers, and a diverse customer base.
- Determine if a complex request should be transferred to a pharmacist for assistance.
- Maintain complete, timely, and accurate documentation of all approvals and denials.
- Pronounce drug names and diagnoses and recognize medical terminology.
- Navigate multiple software systems to document conversations and outcomes.
- Provide schedule flexibility including rotations through nights, weekend and holiday coverage.
Benefits
- Medical coverage
- Dental coverage
- Vision coverage
- Paid time off
- Retirement savings options
- Wellness programs
- CVS Health bonus, commission or short-term incentive program
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
