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Cvs Prior Authorization Remote Jobs in Tennessee

Legion Health

$300K - $500K/yr

... prior authorizations, pharmacy coordination, etc. * Patient Acquisition: Unlike with a private ... Fully remote within the United States. * Schedule: Full-time or part-time positions are available.

Legion Health

$150K - $300K/yr

... prior authorizations, pharmacy coordination, etc. * Patient Acquisition: Unlike with a private ... Fully remote within the United States. * Schedule: Full-time or part-time positions are available.

COMPASSUS

Insurance Specialist

Brentwood, TN · Remote

$20 - $35/hr

Compassus This is a remote position for candidates located in the Pacific Time Zone. Initial ... One (1) or more years of insurance authorization experience preferred. * Prior experience in the ...

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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 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 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 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 September 2026, with employment types broken down into 50% Full Time, and 50% Part Time. Highlights an 100% Remote job distribution.

Medical Billing Specialist - Remote

American Health Partners

Parsons, TN • Remote

$14.75 - $19/hr

Full-time

Posted 18 days ago

Job description

JOB SUMMARY:

The Medical Billing Specialist is responsible for processing and mailing/transmitting claims, tracking claims, monitoring authorization and eligibility of payor benefits, managing the collections process and posting cash receipts.

ESSENTIAL JOB DUTIES:

To perform this job, an individual must accomplish each essential function satisfactorily, with or without a reasonable accommodation.

  • Extract and verify billing information from medical records
  • Ensuring collection of past due balances; follow up as needed
  • Ensure all patient demographic and insurance is accurate prior to submitting claims to insurance companies
  • Answer patient account inquiries; assists establish alternative payment plans when necessary
  • Maintain patient account records; settle third party payer issues as required
  • Receive and review Daily Reconciliation Review (DAR) document for accuracy; enter charges into Practice Management System (PMS)
  • Prepare and review patient statements prior to release through PMS
  • Ensure timely filing of all Medicare, Medicaid, and third-party insurance claims
  • Balance daily charges; reconcile with reports within PMS
  • Collaborate with revenue cycle manager and payers on denials/rejections
  • Work closely with practice representatives to ensure proper insurance verifications and authorizations are obtained
  • Other duties as assigned

JOB REQUIREMENTS:

  • Comply with applicable legal requirements, standards, policies and procedures including but not limited those within the Corporate Compliance Program, Corporate Code of Conduct, HIPAA, and Federal False Claims Act
  • Report concerns and suspected incidences of non-compliance immediately to the Chief Compliance Officer
  • Communicate professionally with patients and guarantors regarding balances or account information
  • Participate in required orientation and training programs
  • Cooperate with monitoring and audit functions and investigations
  • Participate in process improvement responsibilities
  • Meet productivity goals
  • Successful completion of required training
  • Handle multiple priorities effectively

REQUIRED SKILLS:

  • Problem solving skills to manage a variety of concrete variables
  • Effective verbal and written communication skills
  • Ability to interpret instruction presented in variety of situations
  • Strong organizational skills; ability to manage multiple projects simultaneously
  • Proficiency with Microsoft Word, Excel, PowerPoint, and Internet Explorer
  • Ten key speed and accuracy

EQUAL OPPORTUNITY EMPLOYER

This Organization is an equal opportunity employer. We do not discriminate based on race, color, religion, sex, handicap, disability, age, marital status, sexual orientation, national origin, veteran status, or any other characteristic(s) protected by federal, state, and local laws. This Organization will make reasonable accommodations for qualified individuals with disabilities should a request for an accommodation be made. A key part of this policy is to provide equal employment opportunity regarding all terms and conditions of employment and in all aspects of a person's relationship with the Organization including recruitment, hiring, promotions, upgrading positions, conditions of employment, compensation, training, benefits, transfers, discipline, and termination of employment.

American Health Partners logo

About American Health Partners

Sourced by ZipRecruiter

American Health Partners is a family of six divisions staffed by outstanding employees who care deeply about others. Since our inception more than 45 years ago, we have been committed to bringing the highest quality healthcare available to our communities. That commitment continues to serve us, our patients, our customers and our partners well. Today, our diverse healthcare offerings serve nearly 12,000 individuals annually across multiple states. We operate in both urban and rural communities where people need healthcare close to home. By working closely with hospitals and other providers, we offer cost-effective options that give individuals greater control over their healthcare.

Industry

Health care and social assistance

Company size

1,001 - 5,000 Employees

Headquarters location

Franklin, TN, US

Year founded

1976

Social media

Facebook

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