Prior Authorization Representative

September 25, 2026

Job Description:

Serve as the initial point of contact for Prior Authorization requests from members, providers, and a diverse customer base
Determine whether complex requests should be transferred to a pharmacist for assistance
Maintain complete, timely, and accurate documentation of approvals and denials
Document conversations and outcomes across multiple software systems

Requirements:

1 year experience in customer service or call center environment
Must be able to work from home
High-speed internet
Proficiency pronouncing drug names and diagnoses
Ability to recognize medical terminology
Ability to navigate multiple software systems
Keyboarding skills
Schedule flexibility, including rotations through nights, weekends, and holidays
High School Diploma or equivalent GED

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 (eligible in addition to base pay)

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