Description of the list below. All positions are remote, however the following states will require you to be fully vaccinated to work in the office.,
Kentucky, Tenn., IN.ID, WY, UT, MT, & AZ FL, OH, UT AZ and virtual location
Work from Home within specific Time Zones of Pacific and Mountain
A few positions qualify for a sing-on bonus of $2000 Sign-On Bonus, so pay attention to details. The pay is not disclosed, however, you can find the answer to your question as you follow the Cigna employee review page
Cigna Corporation exists to improve lives. We are a global health service company dedicated to improving the health, well-being, and peace of mind of those we serve. Together, with colleagues around the world, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas, and an unwavering commitment to patient-centered care, we are a force of health services innovation. When you work with us, or one of our subsidiaries, you’ll enjoy meaningful career experiences that enrich people’s lives. What difference will you make
Must be a current contractor with Cigna, Express Scripts, or Evernorth. Evernorth is a new business within Cigna.
Responsibilities:
Responsible for educating the membership on their targeted options.
Ability to utilize multiple resources: client websites and navigate search engines to find the Web-texbest places of care that offer convenient distances for client members while holding a successful and fluent conversation on the phone with the member.
Can effectively utilize multiple internal system platforms: ISSAC, Image1, or both.
Ability to use internal resources on hand (evi, Web-tex Teams, Team Educators) to problem solve.
Adhere to a schedule.
Work from home, ID, WY, UT, MT, & AZ - Express Scripts
What You Should Have:
High School Diploma / GED required
2-3 years of relevant customer service experience
General PC knowledge including Microsoft Office
Excellent communication skills (verbal and written)
Willingness to work a flexible schedule.
A strong customer service orientation and commitment to providing outstanding service.
Impeccable attention to detail
High Degree of Professionalism and a robust work ethic
The ability to work independently and as a reliable team member
An upbeat attitude with a coachable persona
Inquisitiveness and the desire to continually learn and improve
Virtual Work at Home Requirements:
Internet: Employees must maintain an Internet connection that meets the minimum criteria defined by the IT Support team. This is solely at the cost of the employee Minimum Internet speed: 1MBPS upload/1 MBPS download - Cable broadband or Fiber Optic.
NOTE: You will be required to have reliable internet connectivity provided through a wired connection. A mobile or hot spot environment is not acceptable and you may need to purchase an Ethernet cord depending on your current setup.
Soft Skills:
Aptitude for dealing with complex/challenging customers and demonstrated ability to deescalate a situation, coachable, willingness to learn, enhanced collaboration skills, team player, dependable, punctual, flexibility to different personalities & situations, great attitude, problem solver, professionalism, and an ability to recognize the importance of educating and assisting the members we serve.
Qualifications:
Minimum Education, Licensure, and Professional Certification requirement: High school diploma or GED
Minimum Experience required: 1+ year previous experience in a contact center setting on outbound calls or dialer experience ideally preferred, and or telephonic sales experience, reliable transportation, phone skills, computer skills, basic Microsoft Excel, Microsoft Outlook, and Web-ex Teams (Internal) skills. Must be able to type more than 30 words per minute.
Customer Service Skills (history of customer service exp) preferred, and must have a friendly and professional voice and tone.]
Here’s a little more about what you’ll do:
Help clients, customers, and health care providers understand our business a little better. Topics like determination of payments and claims related to medical and dental procedures and office and hospital visit costs are common questions.
Make it easy for customers to work with us. Take ownership of their issues and do your best to resolve them over the phone the first time, every time.
Be an advocate for health and wellness. Educate customers on disease management programs and make recommendations on the right healthy living programs for their needs.
Enjoy regular development opportunities and mentorship as you train with the best team in the industry. We offer extensive, hands-on training and guided on-the-job training to ensure you’re successful here. (And enjoy your job too!)
What you should have:
Must be willing to work a designated shift between 8 am-8 pm EST , Monday through Friday
High School Diploma or equivalent required, Associates or Bachelor’s degree preferred
1+ years of customer service experience analyzing and solving customer problems required;
Intermediate proficiency in Microsoft Office Suite; high-level capacity to multitask independently and on a computer
Knowledge of Medical Terminology a PLUS
Excellent written and oral communication skills
Exceptional organizational and time-management focus.
What you should have:
High School Diploma or equivalent required, Associates or Bachelor’s degree preferred
1+ years of customer service experience analyzing and solving customer problems required;
Intermediate proficiency in Microsoft Office Suite; high-level capacity to multitask independently and on a computer
Knowledge of Medical Terminology a PLUS
Excellent written and oral communication skills
Exceptional organizational and time-management focus
**This role is Work At Home which allows most work to be performed at home. Employees must be fully vaccinated if they choose to come onsite.
This position is not eligible to be performed in Colorado.
POSITION SUMMARY
Utilizes advanced knowledge to prepare and review claims approaching timely filing to ensure billing accuracy and to edit, bill, and collect payment on outstanding claims in pursuit of reducing the company's accounts receivable. Requires complete understanding of the billing and collection processes and little supervision for routine work.
ESSENTIAL FUNCTIONS
Prepares and reviews claims to ensure billing accuracy according to payor requirements, including but not limited to codes, modifiers, pricing, dates and authorizations.
Pursues collection activities to obtain reimbursement from payors and/or patients including making outbound calls. Contacts payors to request overrides, retro authorizations, additional documentation, window extensions, etc. to ensure invoice has necessary elements for reimbursement or to work a rejected claim (denial).
Frequent follow up with payers and/or patients on outstanding accounts.
Responds to billing inquiries and questions relating to patient accounts.
Helps with special projects when needed.
QUALIFICATIONS
HS Degree (or equivalent).
3+ years relevant experience.
Exceptional PC skills including Microsoft Outlook, Excel, Word, and Internet
Detail-oriented and strong organizational skills.
Self-starter and team player.
Focus on quality and service.
Demonstrated ability to meet multiple deadlines and manage a heavy workload.
Integrity to handle sensitive or confidential information is critical.
$2000 Sign-On Bonus
**Partial payment after 45 days, 90 days, and 9 months of employment.
Care Advocate. Our Patient Care Advocates have dedicated team members who excel at customer service, helping us elevate our patient care to new heights. In this crucial role, you are on the front lines with patients, responding to phone inquiries and addressing each with care, detail, and most importantly, empathy. Here’s a little more on how you’ll make a difference: • Help patients understand their pharmacy benefits better. Use the knowledge you gain from training, your problem-solving skills, and support from your team to answer patient calls effectively. • Help us keep track of our patient interactions. While on calls, use your expert listening skills to get to the heart of a patient’s question quickly and document all interactions in real-time. • Ensure patients are equipped with the best advice. Identify and empathetically address patient concerns and, if necessary, escalate appropriately.
This role is WAH(Work At Home) /Flex which allows most work to be performed at home. Employees must be fully vaccinated if they choose to come onsite.
What you’ll love about working here:
$2000 Sign-On Bonus*
Fun, friendly, and unique culture – Bring your whole self to work every day!
Choice of three unique medical plans
Prescription Drug, Dental, Vision and Life Insurance
Employee Contributions for HRA and HSA accounts
401K with Company Match
Paid Time Off and Paid Holidays
Tuition Assistance
ESSENTIAL FUNCTIONS
Use of internal pharmacy and scheduling programs for the documentation and nurse scheduling of home infusion visits.
Proactively communicate to field staff, nurse management, and patients.
Investigate/research issues and provide resolution.
Take initiative for problem-solving with the ability to multitask effectively and use critical thinking.
Correct and timely entry of data in appropriate systems.
A pro-active work ethic with the 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, problem-solve, and make independent decisions.
Role Responsibilities:
Implements, updates, and maintains automated, direct connect, and/or manual eligibility data. May handle National Accounts or more complex accounts. Reconciles accounts for non-standard requests. May provide technical support for the electronic procession of eligibility Ensures customer data is installed accurately and timely. Analyzes formats that are customized directly by the client. May work directly with Systems to design formats. Provides recommendations to decrease errors. Acts as a resource to others on non-routine work. Thorough technical knowledge of manual and automated eligibility.
Requirements:
High School Diploma
2 years of college preferred
Analytical Skills
Customer service experience a plus
Excellent Communication Skills Verbal / Written
Healthcare Insurance Background 3+ years-Required
Medicare C (Medical) and Part D (Pharmacy)
Receive files from CMS - Verify Insurance is Active
Be able to handle heavy Outbound & Inbound Calls (Certain Times of the Yr.)
3rd Party Liability - Deals with Auto Accidents
Microsoft Window Programs (specifically: Excel and Word)
SQL (a plus not required)
This role is Work from home (WFH) which allows most work to be performed at home. Employees must be fully vaccinated if they choose to come onsite
This position is not eligible to be performed in Colorado.
Job Summary:
Responsible for assisting customers in obtaining prescribed medications by working with clinical pharmacy teams, physicians, and pharmaceutical manufacturers.
Core Responsibilities:
Call manufacturers for status updates and to order refills
Call patients to get the required information for the application process and utilize information to complete applications and mail to patients
Update patients on the status of applications
Update tracking spreadsheets
Answer questions from patients and pharmacists
Utilize company systems to update needed information for application completion and submission.
Review processes and duties to reevaluate best practices
Responsibilities include:
Answer complex questions from customers while ensuring a high level of service and maximizing productivity with minimum downtime.
Handle customer correspondence, complaints, and inquiries.
Perform general project management, keeping track of issues and timelines, researching and resolving complex issues, and compiling required documentation for daily activities.
Supporting requests, questions and referrals from internal business partners.
Able to assist patients with topics that allow them how to understand steps needed to help successful application submission.
Minimum Qualifications:
High school diploma or GED required Bachelor’s degree is preferred or equivalent work experience
Licensed Pharmacy Technician Required (CPhT preferred)
Experience in a retail pharmacy, PBM, or Health Plan setting is strongly preferred
Pharmacy operations and process knowledge to understand medication concepts, as well as pronunciations, are strongly preferred
Proficient in Microsoft Word, Excel, and Adobe applications
Self-motivator with strong organizational skills.
Customer Service experience
Effective written and oral communications skills
Care Advocate.
Our Patient Care Advocates have dedicated team members who excel at customer service, helping us elevate our patient care to new heights. In this crucial role, you are on the front lines with patients, responding to phone inquiries and addressing each with care, detail and most importantly, empathy.
Here’s a little more on how you’ll make a difference:
Help patients understand their pharmacy benefits better. Use the knowledge you gain from training, your problem-solving skills and support from your team answer patient calls effectively.
Help us keep track of our patient interactions. While on calls, use your expert listening skills to get to the heart of a patient’s question quickly and document all interactions in real-time.
Ensure patients are equipped with the best advice. Identify and empathetically address patient concerns and, if necessary, escalate appropriately.
What You Should Have:
High School Diploma / GED required
1 year of relevant experience
General PC knowledge including Microsoft Office
Excellent communication skills (verbal and written)
NOTE: We are currently training in a work at home environment, and you will be required to have reliable internet connectivity provided through a wired connection. A mobile or hot spot environment is not acceptable and you may need to purchase an Ethernet cord depending on your current set-up.
Orange, Osceola and Seminole County, FL & Franklin County OH
Our Customer Service Representatives have dedicated team members who excel at customer service, helping us elevate our patient care to new heights. In this crucial role, you are on the front lines with patients, responding to phone inquiries and addressing each with care, detail, and most importantly, empathy.
Here’s a little more on how you’ll make a difference:
Help patients understand their pharmacy benefits better. Use the knowledge you gain from training, your problem-solving skills, and support from your team answer patient calls effectively.
Help us keep track of our patient interactions. While on calls, use your expert listening skills to get to the heart of a patient’s question quickly and document all interactions in real-time.
Ensure patients are equipped with the best advice. Identify and empathetically address patient concerns and, if necessary, escalate appropriately.
What You Should Have:
High School Diploma / GED required
1 year of relevant experience
General PC knowledge including Microsoft Office
Excellent communication skills (verbal and written)
What you’ll love about working here:
Fun, friendly, and unique culture – Bring your whole self to work every day!
Choice of three unique medical plans
Prescription Drug, Dental, Vision and Life Insurance
Employee Contributions for HRA and HSA accounts
401K with Company Match
Paid Time Off and Paid Holidays
Tuition Assistance
Work from Home within specific Time Zones of Pacific and Mountain
The grievances coordinator position is focused on the processing of Medicare customer grievances. This associate may screen incoming complaints received orally or in writing, conducting root cause analysis as needed, creating an action plan, coordinating and communicating resolutions, as well as documenting systems in detail with case notes related to Customer grievances with in CMS guidelines.
Duties and Responsibilities:
Grievance Coordinator is responsible for corresponding with members, providers and regulators regarding decisions and actions.
Works collaboratively with the Claims, Customer Service, Appeals, and Medical Management Departments.
Communicate, collaborate, and cooperates with internal and external business partners.
Adheres to all Compliance/Program Integrity requirements and complies with HIPAA Regulations.
Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency.
Supports department-based goals which contribute to the success of the organization.
CANDIDATE QUALIFICATIONS:
Bachelors or associates degree in related field; in lieu of a degree, a high school diploma and two years in a Medicare, Medicaid managed care environment investigating and resolving Grievances.
One year of health insurance/managed care experience knowledge of healthcare terminology preferable.
Strong written and verbal communication skills, PC proficiency to include Microsoft office products.
One year of health insurance/managed care experience performing Appeals and Grievances functions.
Will consider managed care associates with three years of experience in customer service, call center or claims processing skills and knowledge of healthcare delivery.
Demonstrated ability to manage large caseloads and effectively work in a fast-paced environment.
Demonstrated written communication skills, time management, priority setting, problem solving and organizational skills.
Demonstrated ability to converse with and collaborate with physicians and physician personnel.
Ability to identify and define problems, collect data/information, establish facts, and draw valid conclusions and provide resolution.
Ability to track and manage case load effectively in Grievance tracking system
Must be able to work independently and under pressure related to tight time-frames
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