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 Intake Agent 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.
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
possible mandatory overtime requirements
At least 1 year experience in customer service or call center environment
Previous experience in pharmacy or healthcare industry preferred
High School Diploma or GED equivalent
It's a new day in health care.
Combining CVS Health and Aetna was a transformative moment for our company and our industry, establishing CVS Health as the nation's premier health innovation company. Through our health services, insurance plans and community pharmacists, we're pioneering a bold new approach to total health. As a CVS Health colleague, you'll be at the center of it all.
We offer a diverse work experience that empowers colleagues for career success. In addition to skill and experience, we also seek to attract and retain colleagues whose beliefs and behaviors are in alignment with our core values of collaboration, innovation, caring, integrity and accountability.
CVS Health is an equal opportunity/affirmative action employer. Gender/Ethnicity/Disability/Protected Veteran we highly value and are committed to all forms of diversity in the workplace.
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. We comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW and EEO IS THE LAW SUPPLEMENT.
We provide reasonable accommodations to qualified individuals with disabilities. If you require assistance to apply for this job, please contact our Advice and Counsel Reasonable Accommodations team. Please note that we only accept applications for employment via this site.
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