Prior Authorization Representative

Remote, USA Full-time Posted 2025-04-27

Are you a detail-oriented individual looking to make an impact in the healthcare industry? CVS Health is currently seeking an experienced Prior Authorization Representative to join our dedicated team. In this position, you will be responsible for accurately obtaining and verifying prior authorization requests to ensure members have access to the medications they need. The ideal candidate will have strong problem-solving skills and a desire to learn new concepts quickly. If this sounds like the perfect role for you, we?d love to hear from you!

    Responsibilities:
  • Conduct detailed research to accurately assess prior authorization requests
  • Verify insurance eligibility and coverage for prior authorization requests
  • Obtain and submit appropriate documentation for prior authorization requests
  • Examine and interpret medical records to ensure accuracy
  • Maintain accurate records of prior authorization requests
  • Follow up on requests to ensure timely completion
  • Stay up to date on the latest changes to healthcare policies and regulations
  • Proactively identify areas of improvement to streamline processes
  • Provide excellent customer service to members, healthcare providers, and other stakeholders
  • Answer inquiries in a timely and professional manner

CVS Health is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate based upon race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.

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