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Prior Authorization Representative – CVS Health

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Position Summary

The representative is the initial point of contact for Prior Authorization requests from members, providers, and a diverse customer base. The representative will make determinations if a complex request should be transferred to a technician or pharmacist for assistance. Additionally, they are responsible for maintaining complete, timely, and accurate documentation of all approvals and denials.
To be successful in this role, you will need proficiency in pronouncing drug names and diagnoses and recognizing medical terminology. As well as navigating multiple software systems to document conversations and outcomes, which require keyboarding skills.
This is a call center environment and the representative will be required to take inbound calls.

*This position could require mandatory overtime.

Required Qualifications
Required to provide high-speed internet.
Private dedicated workspace.

Preferred Qualifications

• Previous experience in pharmacy or healthcare industry
• 1+ years’ experience in customer service or call center environments.


Verifiable High School Diploma, GED, or equivalent.



Pay Range

The typical pay range for this role is:


$17.00 – $27.90