We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.
Position Summary
Primary Job Duties & Responsibilities
- Leads and supports a team of Authorization Specialists responsible for obtaining, tracking, and maintaining insurance authorizations for medical services and procedures.
- Serves as a primary point of contact for patients regarding authorization status, insurance requirements, and coverage-related questions, ensuring accurate and timely communication.
- Reviews patient records and insurance information to determine authorization needs, verifies benefits, and ensures compliance with payer guidelines and regulatory requirements.
- Coordinates with insurance carriers, physician offices, and clinical staff to submit prior authorization requests, appeals, and supporting documentation.
- Monitors authorization workflows and daily productivity to ensure all pending, approved, denied, or expiring authorizations are followed up on and resolved within required timeframes.
- Identifies denied or delayed authorizations, investigates root causes, and works proactively to resolve issues to prevent delays in patient care or revenue loss.
- Maintains accurate documentation and updates authorization status in the electronic health record (EHR) and billing systems by close of business (COB).
- Acts as a liaison between patients, providers, and insurance companies to facilitate clear communication and continuity of care.
- Assists leadership with onboarding, training, and ongoing development of Authorization team members, including payer-specific rules and best practices.
- Provides coaching, feedback, and performance guidance to junior Authorization staff through team meetings and on-the-job training, documenting strengths and improvement opportunities.
- Supports department leadership with quality audits, process improvements, and adherence to compliance, payer, and organizational policies.
Required Qualifications
Minimum 1 year experience working in a customer service or call center environment.
Experience verifying benefits with insurance companies
Data entry experience.
Working knowledge in Microsoft Office, specifically Outlook and Word.
Preferred Qualifications
Home infusion or durable medical equipment (DME) experience.
Experience work in a healthcare environment.
Experience working with healthcare ins
Education
Verifiable High School Diploma or GED is required.
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
The typical pay range for this role is:
$18.50 - $35.29
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 offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.
Additional details about available benefits are provided during the application process and on Benefits Moments.
We anticipate the application window for this opening will close on: 08/30/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.