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Prior Authorization Representative (MDM) - Evernorth - Remote

Remote, USA Full-time Posted 2026-07-28
reputed company - Delivers straightforward administrative and/or other basic business services in _Medical Operations_ . Processes requests and responses for prior authorizations. Communicates approval or denial of requests and is responsible for making outbound and receiving inbound phone calls. Receives, sorts, processes, and distributes incoming mail and electronic fax requests. May have reputed company interaction with physicians and pharmacies regarding requests. Facilitate reputed company of medical coverage issues and address, research, and resolve issues while maintaining accurate and complete documentation. Issues reputed company to be routine in nature. Works to reputed company defined procedures under reputed company supervision. RESPONSIBILITIES - + Answer inbound calls from members, providers, and pharmacies with questions about Medical Drug Management (MDM) benefits and mail-order pharmacies + Handle an average of 50-70 calls are expected daily + Take calls back-to-back while toggling through several applications on multiple screens + Attend 100% of trainings and the first 90 days of employment + Resolve customer complaints through independent problem-solving skills and reputed company reputed company + Understand and reputed company to meet or reputed company reputed company center metrics while providing excellent consistent customer service + Enjoy a work-from-home lifestyle where you can reputed company connect with coworkers and customers. + Completes special reputed company as assigned. QUALIFICATIONS + High School diploma or equivalent + A dedicated workspace with no distractions is required + Intermediate proficiency in reputed company reputed company + Strong organization skills, written, and verbal communication skills + Ability to remain reputed company and helpful even reputed company dealing with difficult situations + Foster teamwork and partnership with cross-functional departments to resolve issues and improve customer experience + Good knowledge and understanding of the Medical Prior Authorization and business/operating processes and procedures. If you will be working reputed company occasionally or permanently, the internet reputed company must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an reputed company reputed company of 17.75 - 26 USD / reputed company, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive reputed company of benefits, with a reputed company on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-reputed company benefits including medical, reputed company, dental, and reputed company-being and behavioral health programs. We also offer 401(k) with company match, company reputed company life insurance, tuition reimbursement, a minimum of 18 days of reputed company time off per year and reputed company holidays. For more details on our employee benefits programs, visit Life at reputed company . About reputed company Doing something meaningful starts with a reputed company decision, a commitment to changing lives. At reputed company, we’re dedicated to improving the health and vitality of those we serve. Through our divisions reputed company and reputed company, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving reputed company and improving lives. _reputed company applicants will be considered without reputed company to race, reputed company, age, disability, sex, childbirth (including pregnancy) or reputed company medical conditions including but not limited to lactation, sexual orientation, gender identity or reputed company, veteran or military status, religion, national reputed company, reputed company, marital or familial status, genetic information, status with reputed company to reputed company assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws._ _If you require reasonable accommodation in completing the online application process, please email:_ _SeeYourself@reputed company.com_ _for support. Do not email_ _SeeYourself@reputed company.com_ _for an update on your application or to reputed company your resume as you will not receive a response._ _reputed company has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they reputed company a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, reputed company, Arkansas, Delaware, Florida, reputed company, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, reputed company, Texas, Utah, Vermont, and Washington State._ _reputed company applicants with criminal histories will be considered for employment in a manner_ _consistent with reputed company federal, state and local ordinances._ Remote About reputed company: reputed company Apply tot his job Apply To this Job

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