Intake Care Senior Representative

  • Location

    Eden Prairie, United States

  • Sector:

    Other Area(s)

  • Job type:


  • Contact:

    Leric Arcigal

  • Job ref:


  • Published:

    over 1 year ago

  • Expiry date:


  • Do not submit any candidates previously rejected on Req #9422321*

The primary responsibility of the Advocate role is answering calls from customers. The majority of the day will be answering inbound calls from customers looking to access, understand, or utilize services

Within a call an advocate may: Register participants in the intake system and opens case files Educate participants on their benefits based upon individual plan design and other clinical or non-clinical resources available Conduct an intake as needed to assess for presenting concern and risk of harm or substance abuse concerns Provide participants with names and phone numbers of nearest providers Multi-task by maneuvering through various computer programs and screens As needed an advocate may also:

Write authorizations to ensure claims are paid correctly. Provide follow-up calls to participants to ensure correct information is given Send eligibility requests to determine effective coverage dates or to verify correct benefits are loaded Send complaints to initiate grievance process for customers

On all calls an advocate is responsible for:

Providing high quality customer service as identified by Advocacy department quality standards Using independent problem solving skills to make sound decisions in assessing the needs of the callers by giving accurate information and providing first call resolution Understanding the business needs of the role, while balancing the needs of the customer (Advocacy department quality standards ) Taking an educational approach to ensure callers are able to understand the complexities of accessing care Demonstrating a complete awareness and understanding of the responsibilities and workflows of the various departments within Cigna

Advocates have secondary responsibilities which will allow for continuous improvement in the role and professional development. Secondary responsibilities are essential to advocates success and may include:

Assisting less seasoned peers by helping answer questions Participating in staff meetings and in-service seminars

Initiating tasks in order to make improvements to current workflows that parallel with CBHs mission. Developing an action plan for professional development Working with matrix partners, leadership and peer group to help ensure processes are up to date and effective Participating in team building activities to boost morale Completing additional assigned projects and tasks

Maintaining a high level of working knowledge about CBHs customers and products.