At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary

Follows processes to assist with processing, insurance verification and authorization, revenue cycle management, compliance and documentation, as well as customer service and issue resolution. Provides support in ensuring accurate billing, efficient revenue flow, and compliance with regulations.

Additional Responsibilities to include but not limited to the following:

- The Coordinator I Prior Authorizations Operations, Clinical Services role will be responsible for performing non-clinical activities and functions in accordance with policies and procedures, under the supervision of the Clinical Services Supervisor.
- Responsible for reviewing and maintaining compliance with ERISA, CMS, Medicaid, and client specific requirements.
- Works as part of the team to meet business unit objectives.
- Further responsibilities include performing quality reviews and assisting as a subject matter expert (SME).

-Monitors PA communications for printing and IVRs, processes manual IVRs, light outbound call work, researches communication errors and creates cases for resolution

- Position requires working Saturdays and Sundays; shift start varies from 6:30AM CST to 9:30AM CST.

 

Required Qualifications
- Proficient in Microsoft Office applications (Word and Excel).
- Strong working knowledge of Windows based applications.
- Effective problem solving skills, analytical ability.
- Strong written communication and interpersonal skills with the ability to interpret data.
- Strong data entry skills, with minimum 30-40 WPM.
- Detail oriented with excellent organizational skills.


Preferred Qualifications

- Superior PC skills in Windows based applications

- Superior CAS Admin skills

- Excellent verbal and written communication skills

- Superior soft skills

- Medical / pharmacy terminology background.
Education

High School Diploma or equivalent GED

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$17.00 - $28.46

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.  The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.  This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. 
 

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.

No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 07/01/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.