Prior Authorization Representative (Work from Home)
Core
Initial point of contact for prior authorization requests from members, providers, and customers; determines if complex requests require pharmacist transfer and maintains documentation of approvals and denials.
Role type
Prior Authorization Representative
Builds
Prior authorization decisions and documentation for CVS Health members and providers
Domain
Healthcare / Pharmacy
Deliverable
client delivery
Required skills
Medical terminology proficiency, Drug name pronunciation, Diagnosis recognition, High-speed keyboarding, Multi-software system navigation
Preferred skills
Pharmacy or healthcare industry experience, Pharmacy Technician License
Responsibilities
Handle prior authorization requests, Determine need for pharmacist assistance, Document approvals and denials accurately
Seniority
Entry-level, individual contributor
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