Technician I, Prior Authorizations - Operations

CVS Health

5d•$17 - $34

About The Position

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.

Requirements

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).

Nice To Haves

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

Responsibilities

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.
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.