Remote, Work from Home, United States
Work Schedule: during training, the hours for this position are Mon-Fri 8:30am-5:00pm CST.
Once all of the training is completed, the hours for this position are Mon-Fri 10:30am-7:00pm CST for a period of time until an earlier shift becomes available (if an earlier shift is preferred).
Provider Relations Associate Analyst (Provider Advocate)
The Provider Advocate role is a customer service position within a call center that supports the Cigna Behavioral Health provider network.
Provider Advocate’s are responsible for handling non-clinical inbound calls from providers and their staff regarding mental health and substance use disorder services.
Advocates guide and assist providers and their staff to help them work with Cigna more effectively and reduce administrative issues.
The types of calls a Provider Advocate services may include but are not limited to: inquiries about eligibility, benefits, claim processing, provider demographic updates, or provider contracting.
Due to the wide variety of call types, several applications are required to service these inquiries, and multiple applications are often needed within the same call.
Independent problem solving, multitasking, and technical savvy are essential in order to be able to carry out the responsibilities of this role.
Calls must be serviced in a helpful and professional manner.
The work environment for this position is structured.
Each employee is scheduled a thirty minute lunch and two fifteen minute breaks per day.
This is to ensure adequate phone coverage throughout the day to be able to handle the incoming call volumes.
The primary responsibility of this role is to answer inbound calls from providers and their support staff.
The majority of the day will be spent answering these calls from a queue.
Within a call an advocate may:
Communicate eligibility, benefits, and authorization requirements to providers for their customers who have Cigna coverage
Write authorizations to ensure claims are paid correctly
Interpret claims information using multiple claim platforms, assist the provider with any claim processing issues, or send claims back for reconsideration if necessary
Educate the provider regarding billing procedures, or when there are billing issues
Provide follow-up on issues by making outbound calls when necessary
Send resources to providers via email
Submit a complaint on the provider’s behalf
Independently problem-solve to ensure accurate information is given, and exceptional customer service and first call resolution is achieved
The training for this position consists of two parts – Eligibility and Benefits Training, and Claim Training.
Each part is approximately four weeks long.
Hours during training are 8:30am-5:00pm .
After all of the training is completed, the hours for this position will be 10:30am-7:00pm .
Hours may vary based on business need.
Bachelor’s Degree or higher strongly preferred in mental health or psychology/social work related field or equivalent work experience required
2+ years of experience working in the behavioral health field is required
2+ years of experience working in a customer service environment required.
Strong independent problem solving skills
Intuitive technical capabilities with the ability to quickly understand and apply working knowledge on several proprietary systems
Ability to maintain a professional and positive image to external customers
Candidate must possess superb interpersonal communication skills
Effective listening and organizational skills, with the ability to manage multiple tasks
Ability to type effectively and have strong PC skills (Word, Outlook, etc.)
Ability to adapt well to change and stay up-to-date with frequent workflow changes
This position is not eligible to be performed in Colorado.
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?
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: [email protected] for support.
Do not email [email protected] for an update on your application or to provide your resume as you will not receive a response.
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