Technician I – Prior Authorizations

This is a fully remote position, open to applicants in Virginia.

📋 Description

• Receive incoming calls from providers, pharmacies, members, and various other callers.

• Deliver professional and courteous phone support through the criteria-based prior authorization process.

• Ensure thorough, timely, and precise documentation of reviews.

• Redirect clinical inquiries, escalations, and judgment calls to the pharmacist team.

• Initiate outbound calls as necessary.

• Review and process prior authorizations submitted via fax and ePA.

• Monitor and respond to inquiries in department mailboxes.

• Handle inbound calls, fax requests, and ePA requests in accordance with established standards.

• Communicate with internal teams regarding determination status and outcomes.

• Recognize and escalate clinical inquiries to the pharmacist team.

• Carry out additional tasks such as faxes, sorting, managing email boxes, and maintaining the CAS.

⛳️ Requirements

• High School Diploma or equivalent GED.

• Minimum of 6 months of experience in Customer Service or as a Pharmacy Technician.

• Consistent and reliable attendance.

• Willingness to work mandatory overtime or extended work weeks when necessary.

• Ability to travel when required.

• Fundamental computer skills.

• Proficiency in Microsoft Office Suite: Excel and Word are essential; Access, Outlook, PowerPoint, and Visio are preferable.

• Necessary keyboard skills.

• Capability to multitask and utilize multiple system applications simultaneously.

• Basic understanding of pharmaceutical terminology, calculations, and protocols.

• Ability to independently utilize available resources and deliver high-quality work.

• Capacity to absorb presented information, exhibit motivation, pursue development, and solve problems.

• Flexibility to adapt to changing workflows and shifting priorities.

• Excellent written, verbal, grammar, and listening communication skills.

• Ability to interact with a diverse customer base in a friendly and confident manner.

• Commitment to maintaining the confidentiality of PHI (Protected Healthcare Information).

• Compliance with departmental, corporate, state, and federal regulations.

• Capability for extended periods of sitting, conversing on the phone, and reading a computer screen.

• Home workspace must adhere to CVS Health privacy and security policies and procedures.

🏝️ Benefits

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Additional resources to support physical, emotional, and financial well-being.

• Eligibility for CVS Health bonus, commission, or short-term incentive programs.

• Comprehensive full-time benefits package, based on eligibility.