Prior Authorization Representative - Remote

ABOUT US:

CEF Solutions Inc. is a Consulting Services and Business Process Outsourcing (BPO) company specializing in BPO Operations, Operations Management, Process Engineering and Innovation, Cost Optimization, and Staffing solutions. We take pride in our expertise in providing specialized staffing services, ensuring that clients have access to top talent that aligns with their operational goals. We service some of the largest multinational companies in the world and are expanding quickly by delivering an unmatched end-to-end client experience.

Company website: www.CEF.inc

We are hiring Prior Authorization Representatives to work from home!

Position Overview:

· Location: Work at Home

• Hourly rate of pay: $16/Training; $16.50 Production

· BP Orientation: 11/7/2025

· Product Training: 11/10/2025

• Training Schedule: Mon Fri; 7:30 AM 4:00 PM CST
• Length of Training: 2 weeks training, 2 weeks nesting
• Project duration: Steady State - This project operates without a predetermined end date, and it is based on agent performance and the clients needs
• Hours of Operation (HOOPs): Mon Fri; 7:00 AM 8:00 PM CST

· Production Schedule Post Training:

o An assigned schedule within the hours of operation

· 40 hours per week.

· 8 hours per day + 30 min lunch

• Scheduled 5 days a week

Prior Authorization Representatives will receive inbound phone calls and faxes from members, doctors' offices, or other departments requesting information on prescribed medications prior authorizations only. The representatives will manage the prior authorization process for medications and provide updates on approval status. This is a fully remote role train from home and work from home.

Responsibilities:

• Assisting Prior Authorization individuals with status updates on the authorizations and statuses of the request
• Reviewing medication inquiries and contacting healthcare providers for follow-up information
• Reviewing provider documentation and accurately interpreting and entering data into the database
• Excellent communication (both verbal and written) and problem-solving skills
• Ability to effectively multitask and possess excellent attention to detail
• Self- motivated with the ability to work well independently and as part of a team with minimal direct supervision

Required Qualifications:

• 1+ years of healthcare, claims, or medical administrative work experience
• 1+ years of recent continuous employment with previous employer
• 2+ years of customer service or call center experience
• Computer literate (Microsoft Windows, keyboarding skills, strong systems aptitude)
• Medical and Healthcare terminology knowledge

· Exceptional communication skills

· Strong computer/data entry skills

· High school diploma or equivalent

• Proficiency in Microsoft Office and industry-related software programs
• Ability to work with peers in a team effort and independently resolve issues
• Demonstrated ability to manage multiple priorities and deadlines
• Capability to efficiently complete tasks in a fast-paced environment
• 100% attendance is required during training: No time off within the first 60 days of employment
• Responsible for providing your own 19" monitor or larger with VGA or HDMI port with corresponding cable, USB wired mouse, ethernet cable, and optional USB wired keyboard
• Reliable hardwired internet is a must with at least 25mbps download | 10mbps upload speeds

Preferred Qualifications:

• Candidates with prior experience in managing or processing medication prior authorizations are highly preferred