Call Center/Customer service environment

The initial point of contact for Prior Authorization requests from members, providers, and other callers through the algorithm driven automated criteria based prior authorization process. Maintains complete, timely and accurate documentation of all approvals and denials. Non-yes/no and non-black and white criteria will be transferred to a technician. All clinical questions and judgment calls will be transferred to the pharmacist.

The Rep will also assist with other duties such as outbound calls, monitoring/responding to inquiries in mailboxes and other duties as assigned by the leadership team.

Pay Range
The typical pay range for this role is:
Minimum: 17.00
Maximum: 27.90

Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.

Required Qualifications
1. Excellent customer service skills with the ability to effectively interact with physicians, physician office staff and a diverse customer base
2. Must be able to communicate articulately and comprehend oral, written and verbal communications
3. Basic level of keyboarding skills
4. Strong working knowledge of PC and windows-based applications (i.e. start up and shut down computer, use mouse to point and click, start and close programs, switch between programs, opening a browser, access information on-line, etc.)
5. Must be capable of pronouncing drug names and diagnosis and recognizing medical terminology
6. Ability to maintain patient confidentiality and confidentiality of information
7. Ability to calculate and perform basic mathematical calculations (i.e. addition, subtraction, multiplication, division)
8. Ability to handle multiple tasks and utilize multiple computerized information systems
9. Essential skills in navigating a software system to document conversations and outcomes
10. Ability to perform work in an organized fashion with focus on complete information and time related deadlines
11. Ability to effectively manage calls and off-line intake functions
12. Ability to work with people in a team environment while meeting individual performance goals

**mandatory overtime requirements**

Preferred Qualifications
At least 1 year experience in customer service or call center environment
Previous experience in pharmacy or healthcare industry preferred

Education
High School Diploma or GED equivalent

Business Overview
Bring your heart to CVS Health Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.

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