Job Description

Delivers straightforward administrative and/or other basic business services in Customer Service. Receives requests by mail, telephone, or in person regarding insurance claims/policies. Responds to inquiries from policy holders, providers and/or others for information and assistance. Performs research to respond to inquiries and interprets policy provisions to determine most effective response. Mails or routes claim forms and supporting documentation to various units for final processing. Position typically requires excellent interpersonal skills, ability to understand and interpret policy provisions. Independently responds to inquiries, grievances, complaints or appeals ranging from routine to moderate complexity. Issues tend to be routine in nature. Good knowledge and understanding of Customer Service and business/operating processes and procedures. Works to clearly defined procedures under close supervision.

POSITION SUMMARY

Works within the fast paced environment of the Central Nursing Team to complete non-clinical projects and functions. As a first line of contact, this role will independently assist both internal and external clients within scope by clarifying and researching desired information and resolving non-clinical problems within the nursing department. Works with Nurse Manager and field staff to schedule patient visits for home infusion. Works with pharmacy, reimbursement, and nursing departments as coordinator for nursing referrals. Works with prescribers to fax, track, and obtain nursing orders. Delivers straightforward administrative and/or other basic business services in Customer Service. Works with various staff, departments and prescribers via fax, email, IM, and phone. Responds timely to inquiries from patients, field staff, and other departments for information and assistance. Position requires excellent interpersonal skills, critical thinking, multi-tasking, retention, and flexibility. Independently responds to inquiries ranging from routine to moderate complexity. Issues tend to be routine in nature. Good knowledge and understanding of Customer Service and business/operating processes and procedures. Enhance organization reputation by accepting ownership for responding to new and different requests. Escalate issues as necessary.

ESSENTIAL FUNCTIONS

• Use of pharmacy and scheduling programs for documentation and nurse scheduling of home infusion visits.
• Proactively communicate to field staff, nursemanagement,and patients.
• Investigate/research issues and provide resolution.
• Take initiative for problem solving with ability to multitask effectively and use critical thinking.
• Correct and timely entry of data in appropriate systems.
• A pro-active work ethic with ability to be managed/trained virtually
• Proficiency and use of Excel and Outlook

QUALIFICATIONS

• High School education or GED.
• 3+ years of relevant Customer Service experience.
• Microsoft Office Suite.
• Extremely detailed oriented.
• Excellent written and oral communication skills.
• Ability to adapt in a dynamic work environment, learn quickly, solve problems, and make independent decisions.

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.

About Evernorth Health Services

Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. 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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