ZipRecruiter

Log In

2

Cvs Prior Authorization Remote Jobs in Tennessee

next page

Showing results 1-20

All JobsCvs Prior Authorization JobsCvs Prior Authorization Remote JobsCvs Prior Authorization Remote Jobs in Tennessee

Cvs Prior Authorization Remote information

What is a CVS Prior Authorization remote?

A CVS Prior Authorization Remote job involves reviewing and processing medication prior authorization requests for CVS Health from a remote location. Employees in this role evaluate whether prescribed medications meet insurance requirements and communicate with healthcare providers or patients as needed. The job typically requires strong attention to detail, excellent communication skills, and a background in pharmacy or healthcare. Working remotely allows for flexibility while ensuring timely and accurate authorization decisions.

What are the primary responsibilities of a CVS Prior Authorization Specialist working remotely, and how do they collaborate with other healthcare professionals?

As a remote CVS Prior Authorization Specialist, your main duties involve reviewing and processing prior authorization requests for prescription medications, ensuring compliance with clinical guidelines and insurance requirements. You will regularly communicate with physicians, pharmacists, and insurance representatives to gather necessary information and clarify any discrepancies. Collaboration is typically conducted via secure digital platforms, phone, or email. The role requires strong attention to detail, timely decision-making, and the ability to work independently while maintaining high productivity standards in a virtual team environment.

What is the difference between Cvs Prior Authorization Remote vs Cvs Pharmacy Technician?

AspectCvs Prior Authorization RemoteCvs Pharmacy Technician
Required CredentialsCertification in healthcare or pharmacy-related fields, knowledge of insurance and prior authorization processesState pharmacy technician license, certification (e.g., PTCB), knowledge of pharmacy operations
Work EnvironmentRemote, administrative setting focused on insurance and authorization tasksIn-store or pharmacy setting, assisting pharmacists and customers
Employer & Industry UsageHealthcare and pharmacy companies, insurance providersRetail pharmacies, healthcare providers
Common Search & Comparison IntentUnderstanding remote administrative roles in pharmacyUnderstanding pharmacy technician roles and responsibilities

While Cvs Prior Authorization Remote involves handling insurance approvals remotely, Cvs Pharmacy Technicians work directly in pharmacies assisting with medication dispensing. Both roles require pharmacy-related knowledge but differ in work environment and specific credentials.

What are the key skills and qualifications needed to thrive as a CVS Prior Authorization Specialist remote, and why are they important?

To thrive as a CVS Prior Authorization Specialist (Remote), you need a solid understanding of pharmacy benefits, insurance processes, and medical terminology, often supported by a pharmacy technician certification or relevant experience. Familiarity with prior authorization systems, electronic medical records (EMRs), and CVS-specific platforms is typically required. Strong attention to detail, excellent communication, and problem-solving abilities are crucial soft skills for efficiently handling patient and provider inquiries. These competencies are essential for ensuring accurate and timely medication approvals, which directly impact patient care and satisfaction.

What are the most commonly searched types of Cvs Prior Authorization jobs in Tennessee?

The most popular types of Cvs Prior Authorization jobs in Tennessee are:

What are popular job titles related to Cvs Prior Authorization Remote jobs in Tennessee?

For Cvs Prior Authorization Remote jobs in Tennessee, the most frequently searched job titles are:

What job categories do people searching Cvs Prior Authorization Remote jobs in Tennessee look for?

The top searched job categories for Cvs Prior Authorization Remote jobs in Tennessee are:

What cities in Tennessee are hiring for Cvs Prior Authorization Remote jobs?

Cities in Tennessee with the most Cvs Prior Authorization Remote job openings:

Cvs Prior Authorization Remote jobs near you
Infographic showing various Cvs Prior Authorization Remote job openings in Tennessee as of August 2026, with employment types broken down into 91% Full Time, and 9% Part Time. Highlights an 100% Remote job distribution.

Revenue Cycle Associate - Financial Clearance

Quorum Health

Brentwood, TN • Remote

Full-time

Medical, Retirement, PTO

Posted 4 days ago

Quorum Health rating

6.5

Company rating: 6.5 out of 10

Based on 8 frontline employees who took The Breakroom Quiz

Job description

Revenue Cycle Associate - Financial Clearance

Employment Type: Full Time
Location:  Remote
Reports To: Manager, Financial Clearance

You must reside in one of these states to be eligible for this position:

Arkansas                  California                 Kentucky
Massachusetts                Nevada                    New Mexico
Oregon                  Utah                      Tennessee
Texas                     Wyoming

Job Summary:

The Revenue Cycle Associate, Financial Clearance position is responsible for ensuring that a patient’s visit is financially cleared prior to the date of service. The role includes verifying patient insurance eligibility/benefits, calculating patient liability estimates, securing prior authorization, providing notice of admission, obtaining referrals, and verifying medical necessity. These efforts will result in increased net revenues by reducing front-end related denial write-offs. Interactions will be conducted with providers, payers, patients, and hospital-based personnel. Duties are to be performed accurately and timely while providing exceptional customer service.

Key Responsibilities:

  • Ensures Financial Clearance (e.g., verification of eligibility/ benefits, securing prior authorization, etc.) is obtained timely prior to the patient’s date of service based on service line and departmental policies.
  • Performs coverage discovery using eligibility tools to identify additional insurance coverage if existing insurance on file is inactive.
  • Calculates and clearly documents patient liability estimates based on patient’s verified benefit information.
  • Provides payers with timely inpatient and observation Notices of Admission (NOA) as required based on payer-specific guidelines.
  • Validates prior authorization has been obtained and follows up with providers via phone as required for applicable services lines.
  • Verifies medical necessity for applicable patients and identifies instances where a Medicare Advance Beneficiary Notices of Noncoverage (ABN or NONC) is required.
  • Escalates instances where Financial Clearance may not be obtained (e.g., unable to obtain authorization) prior to patient’s DOS to appropriate stakeholders in accordance with departmental deferral policies.
  • Resolves insurance coverage and authorization information discrepancies as identified through automated quality assurance tool.
  • Works denials related to referral, authorizations, notifications, non-coverage, and medical necessity as assigned. This includes, but is not limited to, coordinating with appropriate stakeholders to submit rebills or appeals and obtaining retro authorization when required.
  • Observes privacy, safety, and security procedures, and uses equipment and materials properly.
  • Possesses the ability to work within a remote call center environment, free from distractions and background noise. 
  • Recognizes and consistently exhibits exceptional customer service as a critical factor in all duties performed.

Required Skills & Qualifications:

  • Proficient in typing.
  • General knowledge of medical terminology.
  • Ability to communicate effectively and professionally in English, both verbally and in writing. 
  • Critical thinking and problem-solving skills.
  • High school graduate or equivalent.
  • One year of related experience in the medical field is preferred. 

Benefits:

  • Competitive salary and benefits package.
  • Opportunities for professional development and advancement.
  • Supportive work environment with a collaborative team.
  • Comprehensive healthcare coverage.
  • Retirement savings plan.
  • Paid time off and flexible scheduling options.
  • Student loan repayment program.

What Quorum Health employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply