Positions are located in all 50 US states, Some especially in the following: Minnesota, Kansas, Alabama, Tennessee, Texas, Arizona. For salaries, please follow the link below.
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 you will do
Provides guidance and collaboration in completing the analysis, information, or process mapping, with other workforce management leads
Serve as administrative support for the NICE IEX and WebStation workforce management application. Troubleshoot inquiries from call center partners. When applicable, escalate to CSC for complex inquiries
Communicate “Next Day” staffing recommendations and scheduling updates at Daily Production Touchpoint Meetings
Create optimum staffing scenarios for call center shift bids during peak and off-peak periods based on projected call volume and call metrics
Perform routine audits on intake systems such as SharePoint and WFM mailboxes
Develop and foster a partnership across WFM functional pillars to determine call center staffing during Cigna recognized holidays and/or weather-related incidents drafting strategic plans as needed
Provide ad-hoc research and analysis of data and problems of varying complexity to key stakeholders with often short turnaround times
Performs other related duties as assigned
Qualifications
High school diploma or GED; bachelor's degree preferred
3 years experience in a call center environment
1-year experience in resource management/workforce planning required; additional years of experience preferred
Knowledge of Microsoft Office applications; experience with Real-Time Management systems and tools (i.e., WFM, IEX, Verint, or similar)
Demonstrated understanding of call center processes and procedures
Excellent phone, oral, and written communication skills
Ability to adapt to a dynamic work environment and make independent decisions
Demonstrated ability to handle multiple projects simultaneously and prioritize workload
Extremely detail-oriented
Advanced problem-solving skills and the ability to work collaboratively with other departments to resolve complex issues with innovative solutions
Willingness to work a flexible work schedule
( Nursing Department) Express Scripts
ESSENTIAL FUNCTIONS
Use of 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 professional communication skills.
Ability to adapt in a dynamic work environment, learn quickly, solve problems, and make independent decisions.
Work from Home $86,900 - $144,900,
Primary Functions
Creates, distributes, and maintains enterprise-wide strategic, operational, and tactical plans for resource deployment, a balanced and level loaded workflow, and output expectations to ensure cost and service metric attainment
Creates and maintains standard scheduling processes and guidelines
Leads and coaches Resource Planning staff to ensure performance objectives and service metrics are met
Provides retrospective analysis of schedule performance and continuously improves the process
Presents scheduling metrics to senior management and/or site leadership as required
Ad hoc analysis, support of continuous improvement initiatives, and other duties as assigned
Key Competencies
BA/BS degree preferred; MBA preferred
6-8 years relevant experience in a complex multi-skilled / multi-site call center environment
Demonstrated leadership skills; experience managing remote exempt staff and driving results in a virtual environment
Excellent PC knowledge including Microsoft Office (specifically Excel), Internet, Workforce Management solutions (WFM, Intradiem, NICE, Verint, Decisions, Genesys)
Strong analytical and technical skills
Excellent communication and presentation skills and the ability to influence without direct authority
Ability to adapt in a dynamic work environment, learn quickly, solve problems and make decisions with minimal supervision
Advanced problem-solving skills and the ability to work collaboratively with other departments to resolve complex issues with innovative solutions.
The Representative reviews submitted applications and must interpret notations left by the New Business division and present the information to the callers (either agents or applicants.)
The Representative is familiar with Commissions payments and schedules in order to assist with agents’ inquiries regarding their compensation.
The representative will assist other members of the team with complex issues.
Job Responsibilities:
Receives requests via telephone regarding Insurance application status and Commissions.
Responds to inquiries from Independent and Cigna Agents and/or agencies for information and assistance.
Performs research to respond to inquiries and interprets notifications to determine the most effective response.
Independently responds to inquiries, grievances, complaints or appeals ranging from routine to moderate complexity.
Schedule may vary based on needs of business but core working hours are: Monday-Friday 8-5:30 CST
Performance is determined on many factors including phone metrics and quality assurance scores.
Minimum Qualifications:
Associate’s Degree and/or 2+ years’ work experience in customer service- call center preferred
Previous work experience in customer service required
Ability to handle complex customer issues in a professional and calm manner
Must be a current contractor with Cigna, Express Scripts, or Evernorth. Evernorth is a new business within the Cigna Corporation.
The Representative reviews submitted applications and must interpret notations left by the New Business division and present the information to the callers (either agents or applicants.)
This role is Work from Home which allows most work to be performed at home or on occasion at a Cigna office location. Employees must be fully vaccinated if they choose to come onsite.
Job Responsibilities:
Receives requests via telephone regarding Insurance application status.
Responds to inquiries from Independent and Cigna Agents and/or agencies for information and assistance.
Performs research to respond to inquiries and interprets notifications to determine the most effective response.
Independently responds to inquiries, grievances, complaints or appeals ranging from routine to moderate complexity.
Schedule may vary based on needs of business but core working hours are: Monday-Friday 8-5:30 CST
Performance is determined by many factors including phone metrics and quality assurance scores.
Minimum Qualifications:
Associate’s Degree and/or 2+ years’ work experience in customer service- call center preferred
Previous work experience in customer service required
Ability to handle complex customer issues in a professional and calm manner
Must be a current contractor with Cigna, Express Scripts, or Evernorth. Evernorth is a new business within the Cigna Corporation.
Work from home - AL, TN, TX, AZ
Responsibilities:
Receive requests for authorization from hospitals, providers, customers, and vendors via fax, phone, and portal
Meet service level goals (e.g., Grade of Service, Average Handle Time, Average Speed to Answer, abandonment rate)
Determine authorization requirements based on company policy, member benefit grid, and provider status
Review customer coverage and benefits
Review authorization requests and make determinations on correct authorization process (i.e. auto approve, refer to Utilization Management Nurse)
Maintain benchmark standards for TAT (Turn-Around-Time) as established by the organization.
Professional demeanor and the ability to work effectively within a team or independently
Flexible with the ability to shift priorities when required
Maintains regular and acceptable attendance in accordance with Time Away From Work policy
Ability to work evening, weekend, and holiday shifts to support the UM Department
Other duties as requested
Qualifications:
High School Diploma and preferred one or more years experience in a managed care environment
Proficient in medical terminology, CPT, HCPCS, and ICD-10 coding
Effective oral and written communication skills
Strong customer orientation
Substantial knowledge of Microsoft Office including Outlook, PowerPoint, Excel, and Word
Excellent typing skills
Knowledge, Skills, Abilities Required:
Excellent interpersonal and communications skills with nursing staff, physicians, nurse practitioners and other health workers involved in the care of a customer
Ability to meet deadlines and manage multiple priorities, and effectively adapt and respond to complex, fast-paced, rapidly growing, and results-oriented environment
Proficient knowledge of departmental policies and procedures
Knowledge of Medicare Regulatory Requirements.
Memphis TN - Accredo
As an Eligibility Representative, you will be part of a team passionate about helping our patients with billing and ensuring their access to life-saving medications.
What you’ll do:
Facilitates cross-functional resolution of drug coverage issues & proactively address, research & resolve issues impacting referral turn-around time
Independently resolve basic patient claims issues using key subject matter knowledge
Prepare and review claims to ensure accuracy to payer requirements, including but not limited to codes, dates, and authorizations
Effectively collaborate with internal departments to resolve issues or provide any needed information
Contact benefit providers to gather policy benefits/limitations
Coordinate and ensure services provided will be reimbursable (e.g., deductible amounts, co-payments, effective date, levels of care, authorization, etc.)
Perform medical/pharmacy benefits verification requiring complex decision skills based on payer and process knowledge
What you’ll need:
High school diploma or GED
3-5 years of relevant working experience
Experience with health care, medical insurance terminology, and patient access preferred
Strong data entry skills and computer skills
Excellent phone presentation and communication skills
Demonstrated ability to handle difficult conversations in a professional manner
Ability to adapt in a dynamic work environment and make decisions independently
Advanced problem-solving skills and the ability to work collaboratively with other departments.
Accredo- Work At Home Arizona
A Reliable internet connection is required.
The shift will be 8:30 to 5 AM AZ time Monday-Friday during daylight savings and 9:30 to 6 pm AZ time Monday-Friday after daylight savings(starting November through March)
This role could be staffing an Inbound call queue and making outbound calls to patients and or other parties. Can perform various functions based on Department needs.
As an Advanced Therapy Pharmacy Technician, you will be assisting patients in receiving needed medications to help manage rare and/or chronic diseases. You’ll be empowered to engage patients, insurance companies, and multiple departments to process orders and ensure timely shipment of medications. This role is very detail-oriented and you’ll spend the majority of your day working on our computer system and on the phone.
What you need to do the job:
High School Diploma, or GED
Relevant experience or a willingness to learn
Valid Pharmacy Technician license/certification/registration as required by state laws or the ability to obtain one within 1 year of employment. (We can help with these)
Microsoft Office proficiency and data entry skills
Basic math skills (addition/subtraction/multiplication)
Strong attention to detail, accuracy, and quality
Excellent verbal and written communication skills.
Work from home,
POSITION SUMMARY
Follows standard operating procedures to edit, bill, and collect payment on basic outstanding claims in pursuit of reducing the company's accounts receivable. Requires basic knowledge of the billing and collection processes and general supervision for routine work.
ESSENTIAL FUNCTIONS
Prepares and reviews claims to ensure billing accuracy.
Pursues collection activities to obtain reimbursement from payers and/or patients.
Frequent follow-up with payers and/or patients on outstanding accounts.
Escalates delinquent and/or complex claims to Sr. Billing & Reimbursement Specialists for appropriate action.
QUALIFICATIONS
High School Diploma or GED required.
2-3 years relevant experience.
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.
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