[Hiring] Provider Relations & Claims Advocate - Evernorth Behavioral Health @Cigna Healthcare

Remote Full-time
This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description The Claims & PR Advocate is a phone queue-based position responsible for servicing inbound claim-related calls from members, providers, and provider office staff. Advocates will handle back-to-back calls throughout the day, with occasional outbound calls required to resolve claim issues. This role demands strong multitasking, technical proficiency, and independent problem-solving skills. β€’ Answer inbound calls from members and providers regarding claims, contracting, and provider relations. β€’ Work in a structured call queue environment, handling a high volume of calls daily. β€’ Make outbound calls as needed for issue resolution or follow-up. β€’ Use multiple applications during calls to research and resolve inquiries. β€’ Call topics may include: β€’ Claim status inquiries and explanations β€’ Requests for claim reprocessing or adjustments β€’ Provider contract questions and demographic updates β€’ Authorization corrections to ensure proper claim payment β€’ Requests for duplicate EOBs or check reissuance β€’ Escalated issue handling via Advocate Handoff/Help Request (AHHR) β€’ Complaint submissions on behalf of members or providers β€’ Emailing resources and documentation to callers Qualifications β€’ Bachelor’s degree is required β€’ Proven customer service experience β€’ Prior experience in Evernorth Behavioral Care Specialist/Advocacy role preferred β€’ Experience handling behavioral health claims and provider relations calls is a plus β€’ Ability to thrive in a virtual team environment β€’ Strong interpersonal and communication skills β€’ Effective listening and organizational abilities β€’ Technical aptitude with multiple systems and applications β€’ Independent problem-solving and time management skills β€’ Proficient typing and PC skills Requirements β€’ Training Schedule: Monday through Friday, 8:30 AM – 5:00 PM CT β€’ Work Schedule: After training, shifts are Monday through Friday between 7:00 AM – 7:00 PM CT β€’ The recruiter will provide specific shift options β€’ 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. β€’ Hourly rate of 24 - 36 USD / hourly, depending on relevant factors, including experience and geographic location. β€’ Eligible to participate in an annual bonus plan. Benefits β€’ Comprehensive range of benefits focusing on supporting your whole health β€’ Health-related benefits including medical, vision, dental, and well-being and behavioral health programs β€’ 401(k) β€’ Company paid life insurance β€’ Tuition reimbursement β€’ A minimum of 18 days of paid time off per year and paid holidays Apply tot his job
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