Role Description The Representative I, Prior Authorizations is the initial point of contact for Prior Authorization requests from members, providers, and a diverse customer base. The Rep I will make the determination if a complex request should be transferred to a pharmacist for assistance. Additionally, the Rep I is responsible for maintaining complete, timely, and accurate documentation of all approvals and denials.

• Proficiency in pronouncing drug names and diagnoses.
• Recognizing medical terminology.
• Navigating multiple software systems to document conversations and outcomes.
• Schedule flexibility including rotations through nights, weekends, and holiday coverage.

Qualifications

• 1 plus years' experience in customer service or call center environment.
• Must be able to work from home.
• Have high-speed internet.

Requirements

• Previous experience in pharmacy or healthcare industry (preferred).
• Associate's or Bachelor's Degree (preferred).
• Pharmacy Technician License (preferred).
• Verifiable High School Diploma or equivalent GED.

Benefits

• Medical, dental, and vision coverage.
• Paid time off.
• Retirement savings options.
• Wellness programs.
• Other resources, based on eligibility. Apply To this Job