Please mention DailyRemote when applying
See how much of this job your resume covers, and what’s missing.
Want a recruiter to go through it line by line?
Get professional reviewOne click makes a copy of your resume for this role, scores it against the posting, and proposes edits line by line. Your default resume is never changed.
Upload your resume and we draft a letter for this exact role, tailored to what it asks for.
The technician manages inbound calls and electronic requests for prior authorization while maintaining accurate documentation of reviews. They also escalate clinical inquiries to the pharmacist team and assist with administrative tasks such as monitoring mailboxes and processing faxes.
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
Briefly describe the primary functions of the position (i.e., the key areas of responsibilities and key interactions, overall decision-making authority, budget impact, strategic and operational impact, business complexity).
The Tech I Prior Auth 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 Auths received via fax and ePA, monitoring and responding to inquiries via department mailboxes and other duties as assigned by the leadership team.
PRIMARY DUTIES AND RESPONSIBILITIES:
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, state, 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. 5%
Other duties assigned, for example faxes, sorting, email boxes, CAS maintenance, etc. 5%
REQUIRED SKILLS & OTHER MINIMUM REQUIRED QUALIFICATIONS:
- 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).
Required Qualifications:
- 6+ months of Customer Service/Pharmacy Technician Experience
- Regular and predictable attendance
- Colleague will be required to work mandatory overtime/extended work week when needed
- Colleague will be required to travel when needed
- Effectively manage work volume by handling inbound calls/fax 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.
Physical Requirements
1. Long periods of sitting (up to 100%)
2. Talking on the phone for extended periods of time (90-100%)
3. Reading a computer screen for extended periods of time (100%)
4. Light lifting of less than 10 lbs (5%)
WORK ENVIRONMENT:
Work in a climate-controlled, smoke-free internal environment; work to be performed regularly in a CVS Health location or from an approved work-from-home location.
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.
Stop the endless job search. Our AI finds and applies to the best jobs for you.
Featuring 219,708+ Jobs in Healthcare
Answer easy questions
219,708+ jobs across 15+ categories
Get your best job matches
Only hand-screened, legit jobs
Find a remote job faster
No ads, scams, or junk
“I was the first applicant for a remote marketing position that got listed on the company website the same day I applied. Had an interview within 48 hours!”