Hours of Position: 9:30A 6:00P (Monday-Friday)
This role is within the Provider Service Unit (PSU). This position is responsible for incoming telephonic customer service and support handling provider inquiries, questions and complaints.
DUTIES AND RESPONSIBILITIES
Responds to provider inquiries, concerns, complaints, appeals and grievances.
Initiates and maintains effective channels of communication with providers and related office staff.
Monitors and track service issues and inquiries and assists with the identification of educational opportunities/programs to improve overall services to the provider network.
Researches problems and negotiates with internal/external partners/customers to resolve highly complex and/or escalated and sensitive issues.
Demonstrates knowledge of providers in assigned geographic area. Understands interrelationships among providers in local market.
Manages appropriate physician correspondence.
Responds to provider inquiries and instructions regarding provider data in CIGNA systems. Coordinates these provider interactions with Provider Relations Representatives and Matrix Partners as necessary.
Manages the batching and Credentialing Required Adds into the eTQS workflow application.
Coordination and handling of physician orientations for new and existing providers (mailing out provider orientation packages, scheduling provider appointments for conference call, confirming appointments via phone).
Provides continuing education of providers via phone on claim submission, claim resubmission and use of provider website and customer service on the status of outstanding claims and electronic submission.
Initiates and maintains effective channels of communication with matrix partners, particularly with provider services staff in the field.
Bachelors Degree required or equivalent work experience
Minimum of 2 years managed healthcare experience
Previous customer service experience required.
Ability to use PC software and multiple CIGNA systems
Ability to problem solve
Previous claim, coding, billing experience preferred
General product(s) and customer knowledge
Solid oral and written communication skills
Excellent influencing and executive presentation skills.
Team player with proven ability to develop strong working relationships within a matrix organization.
Technical/Functional expertise: Customer Service, Provider Services
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 an accommodation based on your physical or mental disability please email: SeeYourself@cigna.com. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.