Description
Assigns client to appropriate staff member or behavioral health network provider for assessment and counseling. Serves as initial contact for clients and their eligible dependents requesting services. Responsible for customer service and relevant standards such as telephone response time. May make referrals within stated limits. Experience level: 0 -2 years
To increase operational efficiency of the unit and ensure customer satisfaction by providing accurate information to callers and by performing health services support duties. Expected to provide excellent customer service to all internal and external customers, as well as answer callers¿ questions completely and accurately.
Responsibilities
Collect and data enter case information
Interact with participant and multiple members of the healthcare team
Make referrals to case management based on tool
Use of multiple systems and applications
Handle multiple products and benefit plans
Work under direction of supervisor/manager
Summary Description of Position
To increase operational efficiency of the unit and ensure customer satisfaction by providing accurate information to callers and by performing health services support duties. Expected to provide excellent customer service to all internal and external customers, as well as answer callers questions completely and accurately.
Provide customer contact for incoming calls, performing but not limited to the following activities:
Facilitate the request for prior authorization of inpatient and outpatient services, ensuring timely and accurate responses
Accesses automated system to document cases
Collects and provides data entry of case information
Provides accurate information to callers based on an understanding of customer and service
requirements
Determines the course of action for each call based on pre-established guidelines, channeling to appropriate staff
May redirect or forward calls to clinical staff for further processing
Communicates professionally with callers, patients, healthcare providers, insurance community and specialists, providing and verifying information; explaining processes; answering questions regarding products and services.
Attains established production standards and operational objectives including case documentation and telephone response requirements as established for this level
Provides data entry of case information consistent with established quality and integrity standards.
Handles some routine complaints; secures supervisory assistance with problem solving and decision making
Advises supervisory staff of any concerns or complaints expressed by providers, patients, insured, and customers
Attains established quality assurance standards.
Performs additional unit duties below as appropriate:
Participate on special projects/customer demonstrations
Support and assist with training and precepting as required
Performs outbound calls and activities as assigned
Qualifications
High School Diploma or G.E.D.
Preferred Requirements
Good telecommunications
Prior experience in customer service
Working knowledge of medical terminology, including CPT and ICD9 Coding
Basic knowledge and understanding of Microsoft office
Working knowledge of call center telephone systems.
Ability to adapt and be flexible within fast-paced dynamic environment
Proven data entry skills
Pay Benefits Work Schedule
CIGNA offers a competitive compensation and comprehensive benefits package including health and wellness benefits, 401k plan, and work/life balance programs, as well as opportunities for career growth and development.
How To Apply
We encourage you to complete all questions on the candidate profile if you wish to be considered for this opportunity.
Details:
Job Id:
63700
Annual Salary:
Position Type:
Education Level:
No Selection
Experience Level:
No selection
Posted:
8/4/2009 9:21:46 PM
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