Technician I – Prior Authorizations

Job not on LinkedIn

🔥 0 minutes ago

⚔️ Virginia – Remote

⚔️ Virginia – Remote

💵 $17 - $28 / hour

⏰ Full Time

🟢 Junior

🚫👨‍🎓 No degree required

👻 Ghost score 0%

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

🏥 Healthcare

⚕️ Healthcare Insurance

🛒 Retail

Healthcare • Healthcare Insurance • Retail

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

📋 Description

• Take inbound calls from providers, pharmacies, members, and other callers • Provide professional and courteous phone assistance through the criteria-based prior authorization process • Maintain complete, timely, and accurate documentation of reviews • Transfer clinical questions, escalations, and judgment calls to the pharmacist team • Make outbound calls as needed • Review and process prior authorizations received via fax and ePA • Monitor and respond to inquiries via department mailboxes • Manage inbound calls, fax requests, and ePA requests according to established standards • Communicate with internal groups regarding determination status and results • Identify and elevate clinical inquiries to the pharmacist team • Perform additional duties such as faxes, sorting, email boxes, and CAS maintenance

🎯 Requirements

• High School Diploma or equivalent GED • 6 months of Customer Service/Pharmacy Technician Experience • Regular and predictable attendance • Ability to work mandatory overtime/extended work week when needed • Ability to travel when needed • Basic computer skills • Knowledge of Microsoft Office Suite: Excel and Word required; Access, Outlook, PowerPoint, and Visio preferable • Essential keyboard skills • Ability to multitask and utilize multiple system applications simultaneously • Basic pharmaceutical knowledge pertaining to terminology, calculations, and protocols • Ability to utilize available resources independently and provide high quality work • Ability to absorb presented information, display motivation, seek development, and problem solve • Ability to adapt and change with workflow and shifting priorities • Excellent written, verbal, grammar, and listening communication skills • Ability to deal with a diverse customer base in a friendly and confident manner • Ability to maintain confidentiality of PHI (Protected Healthcare Information) • Compliance with departmental, company, state, and federal requirements • Long periods of sitting, talking on the phone, and reading a computer screen • Home workspace must comply with CVS Health privacy and security policies and procedures

🏖️ Benefits

• Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being • CVS Health bonus, commission or short-term incentive program eligibility • Full-time comprehensive benefits package, based on eligibility