Job description

Job Description
Customer Service Representative
Do you enjoy helping Health Care Professionals? Do you thrive in a fast-paced, customer-focused environment? Then start your rewarding career as a part of our growing Coverage Review Department! Cigna is one of the largest and fastest growing health insurers in the world.
At Cigna, we invest in you. As a Customer Service Representative you are offered extensive, paid, hands-on training and a supportive post-training environment to pave your way to success. Cigna encourages career development and offers continuing educational resources internally and externally to help you in your career advancement.

Role Summary
In this pivotal role, CSRs respond primarily to phone, also fax and online inquiries from health care professionals to assist them through the medication prior authorization process.
The successful candidate will be able to interact appropriately and efficiently with health care professionals using excellent interpersonal and listening skills, critical thinking, and problem solving skills.
The ability to use computer-based resources in a highly effective manner is a must.
Confidently able to educate and provide accurate responses to inquiries is crucial for success.

Primary Responsibilities
Collection of structured clinical data for prior authorization and non-formulary exception requests following the guidance provided in our online prior authorization tools and/or corresponding forms.
Initial screening of requests based on guidance given by online prior authorization tools.
Approves prior authorization requests if the data collected meets the approval specifications.
Refers prior authorization requests that do not meet the approval specifications to a Pharmacist for clinical review.
Independently responds to contacts ranging from routine to moderate complexity. May seek assistance with health care professional service issues of substantial complexity.
Performs research to respond to inquiries and interprets policy provisions to determine most effective response using established departmental procedures, HIPAA regulations, and corporate policies.

Qualifications
Must have competent computer skills, be familiar with Microsoft office and have a working knowledge of Windows operating system.
Excellent interpersonal communication, attention to detail, critical thinking skills are essential
Candidates must have a reliable high speed broad band internet connection
Speed should be equivalent to
10 Mbps for download
5 Mbps for upload
A hard-wired connection is required and a WiFi connection will not suffice.
Candidates must have a quiet and private space designated for work without interruption
Must be able to work any schedule given between 8:00am – 9:00pm Eastern Monday through Friday. There permanent shifts will be provided before the end of class.
Flexibility to support extended hours and overtime as determined by business needs in order to meet customer expectations.
Training Schedule is 9:00 am – 5:30 pm Monday through Friday for 3 weeks and on the job training will follow the same schedule. OJT is typically 2 weeks.
Able to maintain 100% attendance throughout 4 weeks of training and excellent attendance beyond training.
High School Diploma or GED Required.
Generally has one to five years of call center and customer service experience.
Qualified applicants will be considered for employment without regard to race, color, religion, national origin, sex, sexual orientation, gender identity, disability, veteran status.

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 anticipate offering an hourly rate of 17 - 22 USD / hourly, 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 range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group .

About The Cigna Group
Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public 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@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.

The Cigna Group 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 enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.

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