Provider Relations Telephonic Customer Service Representative - Franklin, TN

Cigna Franklin , TN 37064

Posted Yesterday

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.


  • 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: Do not email for an update on your application or to provide your resume as you will not receive a response.

icon no score

See how you match
to the job

Find your dream job anywhere
with the LiveCareer app.
Mobile App Icon
Download the
LiveCareer app and find
your dream job anywhere
App Store Icon Google Play Icon

Boost your job search productivity with our
free Chrome Extension!

lc_apply_tool GET EXTENSION

Similar Jobs

Want to see jobs matched to your resume? Upload One Now! Remove
Customer Service Specialist Franklin (Nashville Area) TN 2133


Posted 1 week ago

VIEW JOBS 1/8/2020 12:00:00 AM 2020-04-07T00:00 WELCOME TO SHERWIN-WILLIAMS Sherwin-Williams is the largest paints and coatings company in the world. With $15.8 billion in sales, more than 4,100 stores, and 140 manufacturing and distribution centers worldwide. Our 60,000 employees across the globe are diverse, innovative and passionate. With a variety of rewarding and challenging opportunities, Sherwin-Williams is a great place to launch and grow a career. Find yours and join us today. This position is responsible for supporting the sales efforts at a Sherwin-Williams paint store, servicing wholesale and retail customers. It will assist customers in person and over the phone by determining needs and presenting appropriate products and services. This involves ensuring that sales transactions are completed accurately, maintaining accurate work order files and formulas, pulling appropriate products from the sales floor or warehouse, and tinting and mixing them to customer specifications. This position will also assist in sourcing products required by customers that are not available in the store and, upon approval, place order and follow up as necessary. Opening and closing the store, making bank deposits, stocking shelves and setting up displays, cleaning store equipment, and loading and unloading trucks are also responsibilities of the position. It may also assist in making deliveries if necessary. BASIC QUALIFICATIONS: * Must be at least 18 years of age. * Must be legally authorized to work in country of employment without sponsorship for employment visa status. * Must be willing to work all scheduled hours and required overtime, which may include evenings and weekends, with or without reasonable accommodation. * Must be able to retrieve material from shelves and floor stacks and lift and carry up to 50 lbs. * Must be able to operate material handling equipment (e.g. hand truck, pallet jack, forklift, etc.). * Must be able to tint paint, therefore, must be able to distinguish the difference between colors. * Must be able to operate a computer and communicate via the telephone. * High school diploma or comparable certification (e.g. GED). PREFERRED QUALIFICATIONS: * Prior experience in a sales or customer service position. * Associate Degree or related college courses. * Customer service skills, including problem solving and handling customer complaints. * Good written and verbal communication skills. * Valid driver's license. Who we are - At Sherwin-Williams, we're proud of the company we keep — our family of loyal employees. To learn about our company and our culture go to Equal Opportunity Employer. All qualified candidates will receive consideration for employment and will not be discriminated against based on race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, age, pregnancy, genetic information, creed, citizenship status, marital status or any other consideration prohibited by law or contract. VEVRAA Federal Contractor requesting priority referral of protected veterans. Sherwin-Williams Franklin TN

Provider Relations Telephonic Customer Service Representative - Franklin, TN