Pharmacy Technician - Prior Authorizations (Work from Home)

About the role

The Tech I, Prior Authorizations plays a crucial role in the healthcare industry by assisting providers, pharmacies, and members through the prior authorization process. They handle inbound calls, process faxed and ePA requests, and communicate with various internal groups to ensure timely and accurate information.

Responsibilities

• Maintain complete, timely, and accurate documentation of reviews.
• Transfer all clinical questions, escalations, and judgment calls to the pharmacist team.
• Assist with other duties as needed, such as outbound calls, reviewing and processing Prior Auths, monitoring and responding to inquiries via department mailboxes, and other tasks as assigned.
• Effectively manage work volume by handling inbound calls/fax/ePA requests with courteous and professional behavior.
• Comply with departmental, company, state, and federal requirements when processing all information to ensure accuracy.
• Communicate with other internal groups regarding determination status and results, including seniors, pharmacists, appeals, etc.
• Identify and elevate clinical inquiries to the pharmacist team as appropriate.
• Perform other duties as assigned, such as faxes, sorting, email boxes, CAS maintenance, etc.

Requirements

• 6 months experience in customer service or call center environment.
• Able to work from home (100% remote position).
• Wired high-speed internet access.
• Basic computer skills, including Microsoft Office Suite (Excel, Word), and knowledge of Access, Outlook, PowerPoint, and Visio (preference).
• Keyboard skills essential.
• Basic pharmaceutical knowledge, including terminology, calculations, and protocols.

Preferred Qualifications

• Able to multitask and utilize multiple system applications simultaneously.
• Able 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 (internal and external) in a friendly and confident manner.
• Ability to maintain confidentiality of PHI (Protected Healthcare Information).

Qualifications

• High School Diploma or equivalent GED.

Pay Range

The typical pay range for this role is $17.00 - $31.30 per hour. 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.