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Cvs Health Prior Authorization Jobs (NOW HIRING)

MC-Rx

Prior Authorization Coordinator

Miramar, FL · On-site

$21 - $23/hr

Manage the full lifecycle of prior authorization (PA) requests in support of manufacturer-sponsored ... Ensure adherence to all regulatory and privacy requirements, including the Health Insurance ...

Curant Health

Prior Authorization Specialist

Smyrna, GA · On-site

$18 - $24/hr

As a Curant Health employee, your role is to deliver on that vision every day by delivering ... The Prior Authorization specialist responsibilities includes: taking in-bound calls from providers ...

St. Peter's Health

Prior Authorization Specialist

Helena, MT · On-site

$16.25 - $21.50/hr

The Prior Authorization Specialist plays a critical role in supporting high-quality patient care by ... fast-paced healthcare environment while contributing to a positive patient experience.

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How much do cvs health prior authorization jobs pay per hour?

As of Jul 20, 2026, the average hourly pay for cvs health prior authorization in the United States is $20.89, according to ZipRecruiter salary data. Most workers in this role earn between $17.31 and $23.08 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive in the Cvs Health Prior Authorization position, and why are they important?

To thrive as a CVS Health Prior Authorization specialist, you need a thorough understanding of insurance processes, medical terminology, and healthcare regulations, often backed by experience in pharmacy, nursing, or healthcare administration. Familiarity with pharmacy benefit management (PBM) systems, electronic prior authorization platforms, and relevant software such as Microsoft Office is critical. Excellent attention to detail, communication skills, and the ability to multitask under pressure are key soft skills for this role. These competencies ensure timely and accurate processing of medication authorizations, directly impacting patient care and satisfaction.

What is a CVS Health Prior Authorization job?

A CVS Health Prior Authorization job involves reviewing medication requests from healthcare providers to determine if they meet insurance coverage criteria. Employees in this role assess prior authorization requests, verify patient information, and apply clinical guidelines to ensure appropriate medication use. They may also communicate with healthcare professionals and patients regarding approvals or denials. This position requires attention to detail, knowledge of insurance policies, and strong customer service skills.

What are the typical daily responsibilities of a CVS Health Prior Authorization specialist?

As a CVS Health Prior Authorization specialist, your daily tasks usually involve reviewing prescription requests, verifying insurance coverage, and working with healthcare providers to ensure that required documentation is complete. You will communicate regularly with physicians' offices, insurance companies, and patients to clarify information and expedite approvals or denials. The role often requires managing multiple cases at once and adhering to tight deadlines, making strong organizational skills essential. Collaboration with pharmacists and claims teams is also common, ensuring that patients receive medications promptly and in line with compliance standards.

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Cvs Health Prior Authorization jobs near you
Infographic showing various Cvs Health Prior Authorization job openings in the United States as of July 2026, with employment types broken down into 1% As Needed, 88% Full Time, 10% Part Time, and 1% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $43,459 per year, or $20.9 per hour.

Prior Authorization Specialist

Riverhills Healthcare, Inc

Cincinnati, OH • Hybrid

$18 - $22/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 2 days ago

Job description

About Us:

For over two decades, Riverhills Neuroscience has been a pioneer in delivering exceptional neuroscience care. Our commitment to excellence extends across diagnosis, education, and treatment for those facing nervous system diseases and injuries.

Position: Prior Authorization Specialist

Location: Norwood Office

Department: Billing

Schedule: Monday-Friday, 8am-4:30pm, Hybrid, 2 days in office, 3 days remote after full in office training.

Pay: $18-22 per hour

Key Benefits for Full-Time Employees:

  • Competitive pay based on experience, minimum $18
  • 401k with Profit Sharing and 4% Company Match
  • Comprehensive Medical, Dental, and Vision insurance
  • Long-Term and Short-Term Disability Insurance
  • Company Paid Life Insurance
  • Paid Holidays
  • Over three weeks of Paid Time Off
  • Continuing Education Reimbursement
  • Uniform Allowance
  • Free Parking

Responsibilities:

As a Prior Authorization Specialist at Riverhills Neuroscience, you will play a vital role in ensuring the efficiency and accuracy of our billing processes. Your responsibilities include:

  • Streamline pre-certification, authorization, and referral processes, ensuring compliance with insurance requirements
  • Coordinate with insurance entities, review organizations, and clinical contacts for effective communication and benefit determination
  • Facilitate peer-to-peer reviews for escalated encounters and address inquiries from providers, staff, and patients
  • Ensure timely and accurate insurance authorizations, conduct medical benefits investigations, and manage authorizations for botulinum toxin procedures
  • Monitor schedules for insurance coverage changes, oversee specialty pharmacy orders, and maintain/update the ordering spreadsheet
  • Initiate patient education on available assistance programs

Background and Experience:

  • 1-2 years of relevant experience in medical billing and/or prior authorization within a healthcare practice
  • Pain Management experience is a plus
  • Experience with an Electronic Medical Record (EMR) and practice management system
  • Knowledge of Medicare/Medicaid and major insurance carrier's guidelines
  • Working knowledge of ICD-9-10 medical coding and billing and medical terminology
  • Superior verbal and written skills are a must, as are sound judgement, maturity, and the ability to establish good rapport with employees, patients, physicians, and vendors

If you're eager to contribute to a world-class healthcare team, apply today. We look forward to welcoming dedicated professionals to contribute to the growth of our practice.

Equal Opportunity/Drug-Free Workplace:

Riverhills Neuroscience is an equal opportunity employer and maintains a drug-free workplace.

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