Job Description

Position Summary

The My Personal Champion Customer Service Senior Representative needs to be an expert with depth of knowledge around medical health plans. This position will require advanced ability to connect with the member, with a depth of knowledge in resolving and navigating through the customer\xe2\x80\x99s complex medical conditions. This position supports customers with benefits, billing, eligibility, complex claim needs, and other related solutions for the customer, clients, and healthcare professionals via phone and email. These positions will also have the expanded responsibility of assisting our Gender Affirming Customers through their medical journey. Candidates must have a proven track record in resolving claims issues, navigating complex health conditions and the embodiment of empathy as their key driver in member experience. Possesses relationship building behaviors including, but not limited to empathy, curiosity, and helpfulness.

Responsibilities

• Responsible for providing high level of service to inbound calls, outbound calls, and email inquiries for customers with more complex medical conditions and/or needs.
• Will educate customer on their medical health plan benefit package to enable optimal health outcomes.
• Conducts in-network provider searches and contacts providers as needed.
• Provides advanced support with prior authorizations, helping to navigate next steps on denials and/or missing information.
• Investigates and resolves escalations, issues, complaints obtaining necessary information from policies, procedures, or practices. When knowledge articles are not available to guide next steps, must be able to determine the best solution or option autonomously and accurately for customer.
• Highly organized with ability to follow-up timely and communicate proactively to customer and other necessary parties.
• May serve as primary contact and liaison between customers, health plans, service centers, and/or functional areas.
• Understands when to seek support by coaches and leadership for issue resolution.
• Responds to inquiries from policy holders where additional information or research is needed.
• Must listen intently and have ability to interpret verbal cues from customers, using technical expertise and breadth of knowledge to determine most effective action or response.

Qualifications

• High School Diploma or GED required.
• 2+ years\xe2\x80\x99 work experience in healthcare call center operations.
• Proven ability to active and passively listen, understand customers current & future needs, and interpret information from others.
• Excellent communication skills in the spoken and written word.
• Creative problem-solving, critical thinking, analytical, and empathy skills are essential.
• Ability to independently seek solutions to customer needs.
• Proven ability to independently manage day in a fast-paced environment.
• Proficiency in Word and Outlook.
• Utilize computer-based resources in a highly effective manner to educate and respond to customer inquiries is crucial for success in this role.
• Ability to be compassionate and empathetic when handling complex customer inquiries.
• Ability to build trust and form an ongoing relationship with the member and family, becoming their trusted advocate.
• Must have a change mindset and be open to and adapt well to frequent adjustments to procedures or guidance.

Training

• Training will be 12 weeks starting either on 03/18 or 3/25

Post Training Hours

• Mon - Fri, 8a - 6p EST.
• Permanent Schedule will be assigned during training.
• No Weekends
• Off on Company recognized Holidays.

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 - 25 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\xe2\x80\x99s why you\xe2\x80\x99ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you\xe2\x80\x99ll 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 .

About The Cigna Group

Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we\xe2\x80\x99re 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.

The Cigna Group