Cigna Healthspring Jobs – Case Management Analyst

Website Cigna

Job Description:

The primary responsibility of the Advocate role is answering calls from customers. The majority of the day will be answering inbound calls from customers looking to access, understand, or utilize services.

Job Responsibilities:

  • Write authorizations to ensure claims are paid correctly.
  • Educate participants on their benefits based upon individual plan design and other clinical or non-clinical resources available
  • Register participants in the intake system and opens case files
  • Using independent problem solving skills to make sound decisions in assessing the needs of the callers by giving accurate information and providing first call resolution
  • Provide follow-up calls to participants to ensure correct information is given
  • Providing high quality customer service as identified by Advocacy department quality standards
  • Multi-task by maneuvering through various computer programs and screens
  • Send eligibility requests to determine effective coverage dates or to verify correct benefits are loaded
  • Provide participants with names and phone numbers of nearest providers
  • As needed an advocate may also:
  • Conduct an intake as needed to assess for presenting concern and risk of harm or substance abuse concerns
  • Send complaints to initiate grievance process for customers
  • On all calls an advocate is responsible for:
  • Understanding the business needs of the role, while balancing the needs of the customer

Job Requirements:

  • Ability to learn new workflows and tasks quickly
  • Previous call center environment experience preferred
  • Ability to manage multiple tasks, setting priorities where needed
  • Effective listening and organizational skills
  • Ability to work independently and be a team player
  • Independently problem solve, with ability to function without constant supervision
  • A demonstrated ability to type effectively; with strong PC skills/word processing experience and ability to learn new computer software systems

Qualification & Experience:

  • Bachelor’s degree in mental health field or psychology/social work related field (can also include: family communications, health coaching, community/public health or other related major). NOTE: This is a non-clinical role and does not require a license
    Superb interpersonal communication
  • Previous customer service experience or related position

Job Details:

Company: Cigna

Vacancy Type: Full Time

Job Functions: Manufacturing

Job Location: Fenton, MO, US

Application Deadline: N/A

Apply Here

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