Customer Review Representatives

Time zone
Type
Full Time
Opening date
Closing date
2 Nov 2021
Views
113

Do you enjoy helping Health Care Professionals? Do you thrive in a fast-paced, customer-focused environment? Then start your rewarding career as a part of our growing Coverage Review Team! Cigna is one of the largest and fastest growing health insurers in the world.

At Cigna, we invest in you. As a Customer Service Representative, you are offered extensive, paid, hands-on training and a supportive post-training environment to pave your way to success. Cigna encourages career development and offers continuing educational resources internally and externally to help you in your career advancement.

Role Summary

In this pivotal role, Customer Review Representatives respond to phone, fax, and online inquiries from health care professionals to assist them through the medication prior authorization process.

The successful candidate will be able to interact appropriately and efficiently with health care professionals using excellent interpersonal and listening skills, critical thinking, and problem solving skills. The ability to use computer-based resources in a highly effective manner to educate and provide accurate responses to inquiries is crucial for success.

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.

Primary Responsibilities

  • Collection of structured clinical data for prior authorization and non-formulary exception requests following the guidance provided in our online prior authorization tools and/or corresponding forms.
  • Initial screening of requests based on guidance given by online prior authorization tools.
  • Approves prior authorization requests if the data collected meets the approval specifications.
  • Refers prior authorization requests that do not meet the approval specifications to a Pharmacist for clinical review.
  • Independently responds to contacts ranging from routine to moderate complexity. May seek assistance with health care professional services issues of substantial complexity.
  • Performs research to respond to inquiries and interprets policy provisions to determine most effective response using established departmental procedures, HIPAA regulations, and corporate policies.

Qualifications

  • Must be able to work any schedule given between 9:00AM and 9:00PM Eastern Time0 Monday through Friday.
  • Flexibility to support extended hours and overtime as determined by business needs in order to meet customer expectations.
  • Able to maintain excellent attendance throughout 5 weeks of training and beyond.
  • High School Diploma or GED Required.
  • Generally has one to five years of contact center/customer service experience.

Must be a current contractor with Cigna, Express Scripts, or Evernorth. Evernorth is a new business within the Cigna Corporation. 

This position is not eligible to be performed in Colorado.

About Cigna

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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