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The Customer Service Representative manages inbound calls and electronic requests to process prior authorizations for prescriptions. They also communicate status updates to internal teams and identify clinical inquiries for pharmacist review.
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: Customer Service Representative (CSR) 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. Certified Pharmacy Technicians (CPhT) are preferred and compensated based experience.
CSR will also assist with other duties as needed to include but not limited to outbound calls, reviewing and processing prior authorizations (PA) for members’ prescriptions received via fax and electronic PA (ePA), and monitoring and responding to inquiries through department mailboxes. Additionally, the CSR will support other tasks as assigned by the leadership team. This is a fast-paced position that requires strong attention to detail and the ability to multi-task effectively.
Responsibilities % Time*:
Effectively manage work volume by handling inbound calls/fax/ePA requests utilizing appropriate courteous and professional behavior based upon established standards. 40%
Comply with departmental, company, and federal requirements when processing all information to ensure accuracy of information being provided to internal and external customers. 40%
Communication with other internal groups regarding determination status and results (seniors, pharmacists, appeals, etc). 10%
Identify and elevate clinical inquiries to the pharmacist team as appropriate. 10%
Required Qualifications:
Education: High School Diploma or GED equivalent.
Preferred Qualifications:
Remote Work Requirements:
Work Schedule(s) available: We are seeking individuals open to working a 40 hour shift/schedule anytime Monday - Sunday between 8am-9pm EST. You will be given a set schedule after training based on business needs
Training: 5 weeks, Monday - Friday 7:00am - 3:30pm MST (100% attendance required)
Career Development Opportunities:
After training you will have the opportunity to earn a Certified Pharmacy Technician Certificate through an apprenticeship program.
The career path from Customer Service Representative to Clinical Support Technician includes:
The progression path from Level I, Level II, and Level III positions within the Prior Authorization (PA) team is a structured path that encourages advocates to widen their knowledge base, take on more responsibility, demonstrate expertise, and reward team members for their proven success and dedication. Each role level builds upon the skills learned in the previous one, with the ultimate goal of enabling technicians to provide superior support and contribute to the overall success of the contact center.
Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:
$17.00 - $28.46This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
Additional details about available benefits are provided during the application process and on Benefits Moments.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
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