Client Account Support Associate Analyst- eviCore- Remote

The Client and Provider Rep (CPR) serves as the liaison between client and internal stakeholders. This role is the initial contact resource for all client and provider issues. This role must have an understanding of the complete workflow of authorizations, the mapping processes, which platform is used and for what, and be aware of specific client's needs.

RESPONSIBILITIES:

• The CPR is responsible for identifying, assessing, and resolving a client's issue that may take several days/weeks. Examples of issues this role encounters are export errors, new errors which haven't occurred before, and the same errors which have occurred before but with other clients or in greater volumes.
• The CPR works with IT to obtain a resolution and communicates the resolution in basic terminology through a client facing format.
• Facilitates communication between clients, providers, IT, and other eviCore healthcare team members.
• Identifies and resolves day-to-day operational problems using defined processes, expertise, and independent judgment.
• Operational problems consist of eligibility issues, authorizations not crossing over platforms, guideline questions, complaints and peer to peer questions.
• The CPR Investigates client and provider issues, recognizes root-causes, and communicates resolution to stakeholders. This role will be responsible for any follow-up work needed for resolving and closing issues.
• Provides excellent quality service to our clients and ensures that there is full understanding of the resolution or action plan.

QUALIFICATIONS:

• High School graduate or GED required.
• 2+ years of provider relations, client services, health care client experience required.
• Must maintain proficiency in all technical applications, technical skills, and system knowledge (V-File, CRM system, SQL).
• Must have ability to learn multiple platforms that contain provider data, member information, authorizations, and claims.

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.

For this position, we anticipate offering an hourly rate of 20 - 30 USD / hourly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

We want you to be healthy, balanced, and feel secure. That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group.

About Evernorth Health Services

Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives.

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 reasonable accommodation in completing the online application process, please email: [email protected] for support. Do not email [email protected] for an update on your application or to provide your resume as you will not receive a response.

The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.