CVS Health

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Intake Agent Prior Authorization Representative

at CVS Health

Posted: 3/30/2020
Job Reference #: 1219096BR
Categories: Sales, Customer Service

Job Description

Job Description
The Intake Agent - Prior Authorization is responsible for the efficient, accurate and timely prioritization and management of work. Provides support to the Prior Authorization Department in meeting client expectations regarding efficiency, service levels, privacy maintenance and quality of decision-making. Responsible for maintaining compliance with ERISA, CMS, and client specific requirements. Works as part of the team to meet business unit objectives. This position is also responsible for receiving calls from physician offices and providing professional and courteous assistance to all callers through the criteria-based process. The Intake Agent will follow criteria question set prompts to facilitate system-generated approvals. Further responsibilities include maintaining complete, timely, and accurate documentation of all requests, communicating to the physician’s office, pharmacies, intake etc. as needed, and transfers all clinical questions and judgement calls to the Pharmacy Technician or Clinical Pharmacist as needed. 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. The Intake Agent will support requirements of the PA team by working as part of a weekend coverage team on a rotating basis where needed.

Required Qualifications
* Ability to deal with a diverse customer base in a friendly and confident manner (internal and external customers).
* Proficient with computer systems and Microsoft Office skills, including Access, Excel and Word.
* Ability to navigate systems in Windows and web-based programs, and quickly learn new applications. Ability to prioritize and manage multiple tasks.
* Demonstrated sense of urgency with assignments.
* Excellent organization skills. Strong detail orientation.
* Demonstrated problem-solving ability.
* Strong verbal and written communication skills. Ability to maintain confidentiality. Knowledge of claim adjudication processes.
* Works well as a member of a team with strong interpersonal skills.
* Seeks ways to collaborate and reach consensus with peers.
* Actively works to build strong working relationships.
* Able to customize messages and deliver to broader audiences.
* Background in creating and maintaining reports a plus.

Preferred Qualifications
* Previous Healthcare Experience and/or Managed Care experience
* Previous Customer Service Experience
* Call Center Experience is a plus
* Excellent written and Verbal Communication Skills
* Ability to efficiently learn external software programs and multitask between several computer applications

Education
Verifiable High School Diploma or GED - Required
Associate's Degree or Bachelor's Degree - Preferred

Business Overview
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.

If technical issues are preventing you from applying to a position, contact Kenexa Helpdesk at 1-855-338-5609 or cvshealthsupport@us.ibm.com. For technical issues with the Virtual Job Tryout assessment, contact the Shaker Help Desk at 1-877-987-5352.

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!