[Hiring] Pharmacy Technician-Prior Authorization @CVS Health
Role Description 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 judgment calls to the pharmacist team.
- Assist with outbound calls, reviewing and processing Prior Auths received via fax and ePA.
- Monitor and respond to inquiries via department mailboxes.
- Effectively manage work volume by handling inbound calls/fax/ePA 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.
- Communicate with other internal groups regarding determination status and results (seniors, pharmacists, appeals, etc.).
- Identify and elevate clinical inquiries to the pharmacist team as appropriate.
- Other duties assigned, for example, faxes, sorting, email boxes, CAS maintenance, etc.
Qualifications
- 6 months experience in customer service or call center environment.
- Must be able to work from home; this is a 100% work from home position.
- Have wired high-speed internet.
- Able to apply basic computer skills; knowledge of Microsoft Office Suite: Excel and Word required; Access, Outlook, PowerPoint, Visio preferable.
- Basic pharmaceutical knowledge pertaining to terminology, calculations, and protocols.
Requirements
- Must be able to multitask and utilize multiple system applications simultaneously.
- 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).
Education
- High School Diploma or equivalent GED.
Pay Range The typical pay range for this role is: $17.00 - $31.30. This 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.
Benefits
- Comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families.
- Medical, dental, and vision coverage.
- Paid time off.
- Retirement savings options.
- Wellness programs and other resources, based on eligibility.