Prior Authorization Representative - Evernorth - Remote

**Prior Authorization Representative (PAR) Job Description** **Role Summary** The Prior Authorization Representative (PAR) reviews and responds to phone and/or fax inquiries from members and/or health care professionals and assists them with medication prior authorizations. \* In this role, system documentation is reviewed, and information is provided in a straightforward, empathetic manner. * Prior authorization is a process to determine if a prescribed medication is covered by a member’s current health plan. **Responsibilities** * Respond primarily to phone inquiries from members, providers and/or pharmacies. (Fax inquiries may be part of the role.) * Facilitate prior authorization requests. * Utilize multiple applications to obtain information. * Follow standard operating procedures (i.e., dept/corporate documentation, HIPAA regulations etc.) to provide accurate information and outcome. * Pro\- actively research and resolve issues, seeking assistance as needed. * Maintain accurate and complete documentation of inquiries. * Work collaboratively with others to ensure best practices are applied. * Understand and strive to meet/exceed call center and other business metrics. * Provide excellent and consistent customer service. * Attend training classes as assigned. * Work on tasks or projects as assigned. **Qualifications** * High School Diploma / GED * 1\+ years call center customer service experience * Excellent customer service and communication skills * Strong organizational skills * Computer skills; including intermediate proficiency in Microsoft Outlook, working knowledge of Windows and the ability to easily navigate across multiple screens and applications. * Healthcare background preferred. * Ability to remain calm and helpful, even when dealing with difficult situations. * Flexibility to support extended hours and overtime as determined by business needs to meet customer expectations. * Able to attain 100% attendance throughout training/on the job training and maintain excellent attendance beyond. * Must live in a DoD SCA County * *Must work any schedule between hours of operation which can range between (but not limited to) 7:00am – 10:00pm Eastern time, Monday through Friday.* * *Training schedule may vary, however typically 9:00 am – 5:30 pm Easter time, Monday through Friday for 4 weeks and an additional 2 weeks for on\-the\-job training.* **Work from Home Requirements** * Reliable high\-speed broadband internet, **hard\-wired** connection (10 Mbps for download / 5 MBPS for upload) * Quiet and private space designated for work without interruption. **Role Competencies** ACTION ORIENTED INTERPERSONAL SAVVY INSTILLS TRUST CUSTOMER FOCUS PLANS AND ALIGNS If you will be working at home occasionally or permanently, the internet connection 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 antici