Prior Authorization Representative

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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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Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

This is what this question poses: When do you focus and start working seriously? What are the hours you work optimally? Are you a night owl? A morning bird? Remote teams can be made up of people working on different shifts and around the world, so you won't necessarily be stuck in the 9-5 schedule if it's not for you...

2. HOW DO YOU USE THE DIFFERENT COMMUNICATION TOOLS IN DIFFERENT SITUATIONS?

When you're working on a remote team, there's no way to chat in the hallway between meetings or catch up on the latest project during an office carpool. Therefore, virtual communication will be absolutely essential to get your work done...

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Many people want to work remotely because of the flexibility it allows. You can work anywhere and at any time of the day...

4. WHAT DO YOU NEED IN YOUR PHYSICAL WORKSPACE TO SUCCEED IN YOUR WORK?

With this question, companies are looking to see what equipment they may need to provide you with and to verify how aware you are of what remote working could mean for you physically and logistically...

5. HOW DO YOU PROCESS INFORMATION?

Several years ago, I was working in a team to plan a big event. My supervisor made us all work as a team before the big day. One of our activities has been to find out how each of us processes information...

6. HOW DO YOU MANAGE THE CALENDAR AND THE PROGRAM? WHICH APPLICATIONS / SYSTEM DO YOU USE?

Or you may receive even more specific questions, such as: What's on your calendar? Do you plan blocks of time to do certain types of work? Do you have an open calendar that everyone can see?...

7. HOW DO YOU ORGANIZE FILES, LINKS, AND TABS ON YOUR COMPUTER?

Just like your schedule, how you track files and other information is very important. After all, everything is digital!...

8. HOW TO PRIORITIZE WORK?

The day I watched Marie Forleo's film separating the important from the urgent, my life changed. Not all remote jobs start fast, but most of them are...

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This is a great question because it shows your comfort level with technology, which is very important for a remote worker because you will be working with technology over time...