Technician I, Prior Authorizations - Operations

This is a fully remote position, open to applicants in Alabama, +42 more states.

📋 Description

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

• Deliver professional and courteous telephone support throughout the criteria-based prior authorization process.

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

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

• Initiate outbound calls as necessary.

• Review and process prior authorizations received via fax and electronic prior authorization (ePA).

• Monitor and address inquiries through department mailboxes.

• Execute other tasks assigned by the leadership team.

⛳️ Requirements

• High School Diploma or equivalent GED is required.

• Basic computer proficiency is necessary.

• Familiarity with Microsoft Office Suite: Excel and Word are mandatory; experience with Access, Outlook, PowerPoint, and Visio is preferable.

• Essential keyboarding skills are needed.

• Ability to multitask and use multiple system applications concurrently.

• Fundamental pharmaceutical knowledge related to terminology, calculations, and protocols is required.

• Capability to independently utilize available resources and produce high-quality work.

• Ability to absorb information, demonstrate motivation, pursue development, and solve problems.

• Flexibility to adapt to changing workflows and shifting priorities.

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

• Proficiency in engaging with a diverse customer base in a friendly and confident manner.

• Ability to maintain the confidentiality of Protected Health Information (PHI).

• An Associate Degree or Bachelor’s Degree is preferred; equivalent work experience may be accepted if neither degree is held.

🏝️ Benefits

• CVS Health bonus, commission, or short-term incentive program in addition to base salary.

• Medical insurance coverage.

• Dental insurance coverage.

• Vision insurance coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

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