• Job Description

  Req#: 23015220

  Work Schedule: Must be able to work a shift that falls between core business hours of 8:00 am – 4:30 pm Monday through Friday in your respective time zone.

  Job Summary:

  Specialty Care Options Senior Representative, will provide exceptional Customer Service, collaborating closely individual health care professionals, facilities, medical directors, case managers, benefit specialists, pharmacists, the Pharmacy Service Center, Cigna Home Delivery, and other appropriate resources and services, to support customers to ensure optimal use of benefits and clinical care in administering injectable infusions.

  Responsibilities include:

  • Serve as an advocate for customers with complex medical/social/financial needs. Moves open issues to next appropriate level necessary, with minimal disruption and/or inconvenience to the customer.
  • Responsible for verifying eligibility, quoting benefits, researching claims, arranging redirection of calls with pharmacists.
  • Refer Clinical questions to supervisor, case management, and/or medical directors.
  • Efficiently provides complete documentation of activities and cost savings calculations per established production standards and operational objectives.
  • Able to prioritize workload according to established guidelines.
  • Integrates with external partners when appropriate.
  • Research complicated cases, i.e., eligibility, escalated cases, etc.
  • Resourceful in problem solving and making cross departmental connections to resolve issues in a timely manner.
  • Handle routine requests from Supervisors; secures clinical or supervisory assistance with problem solving and decision making.
  • Advises supervisory staff and program medical director of any concerns or complaints expressed by health care professionals, customers, and internal partners.
  • Participate on special projects.
  • Support and assist with training as requested.
  • Participating in work groups and team meetings.

  Experience Required:

  • High School Diploma/GED Required.
  • 3 + years of Customer Service and Administrative Support experience required.
  • Excellent organizational, interpersonal, written, and verbal communication skills, including the ability to explain and answer questions clearly and concisely.
  • Proficient in Microsoft Office applications.
  • Ability to adapt and be flexible within fast-paced dynamic environment.
  • Proven data entry skills.
  • Capable of expressing compassion and empathy.
  • Working knowledge of Specialty Pharmacy program and terminology, specialty injectable medications.
  • Working knowledge of calculating program cost savings.
  • Claims Experience- significant knowledge of interpreting and understanding processed claims and benefits.
  • Experience using multiple systems and platforms.

  
  

  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 - 26 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’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll 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 Life at Cigna Group.

  About The Cigna Group

  Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re 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.

• About the company

  Cigna is an American worldwide health services organization based in Bloomfield, Connecticut.

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