Are you the type of person that enjoys helping others? If you have a background in customer service or experience in healthcare, specifically benefits and claims processing, you might be the perfect fit to join our team as a Care Navigator Representative.As a Care Navigator, you’ll proactively support customers and help them understand their Cigna Healthcare medical plans and educate customers on Evernorth programs and services. You’ll do this by actively listening, address customer needs, then offer programs and solutions from their plan.You’ll be expected to go above and beyond with each call, but you won’t be alone. You’ll be on a team of highly trained and skilled professionals that will be there to help you answer difficult questions and offer solutions.YOUR RESPONSIBILITIES:
Provide high level of service for inbound customer calls about their medical benefits by direct messaging, plus you may also provide digital chat support to customers.
Listen and understand customers unique needs, seeking more information through probing questions with the goal of offering programs and services that apply to their past, current or future needs.
Have a strong understanding of the full suite of benefit and programs, and you’ll connect with other teams (Medical benefit, Clinical, Social Work, etc.) appropriately.
Investigate and resolves escalations, determine barriers to care, and help to resolve complaints by reviewing policies and procedures. When scripts or instructions are not available, you’ll determine the best solution and guide the customer.
Proactively offer outreaches to providers, doctor or vendors as needed to bring next steps into action or resolution removing effort from the customer. You may serve as the liason between customers, health plans, services centers, etc.
Takes ownership and provides timely follow-up on any takeaway from customer interactions. i.e., Evernorth app tickets, prior authorizations pending, findings from claim discrepancies, etc.
Assists customer with the Evernorth app including but not limited to 1) Helping download, register, and log into the app; 2) Inform of all app features and highlight navigation steps to find vendor offerings; 3) Educate on Wellness Rewards and value propositions; 4) Troubleshoot app & provide follow-up on tickets submitted for resolution.
Be highly coachable and open to feedback to improve customer experience driving a consistently accurate quality of service.
QUALIFICATIONS:
Associate degree or higher required and/or 4+ years’ work experience in healthcare or customer service field.
Ability to actively listen to understand current needs and complexities while identifying next steps & potential future needs.
Excellent written and verbal interpersonal communication skills.
Adept with Knowledge Exchange & initiative-taking resource utilization.
Confidence with technology, innovational progress, and ability to toggle three or more systems.
Creative problem-solving and analytical skills with self-awareness of time to resolution.
Proven record of working independently to manage day in a fast-paced, quality driven environment.
Proficiency in Outlook and WebEx.
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 21 - 31 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 GroupDoing 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: [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.Qualified applicants with criminal histories will be considered for employment in a mannerconsistent with all federal, state and local ordinances.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.