Eden Prairie, United States
11 months ago
- Do not submit any candidates submitted and/or previously rejected on Req #9487694*
The manager is seeking candidates in both the Eden Prairie location and Fenton, MO location (1400 S Highway Dr, STE 200, Fenton, MO) and will select the best candidates between the two locations. Please specify which location the candidate is located on their resume.
- Please find attached qualifying questions that should be used to source for this requisition*
Provider Advocate RoleTelephonic Position - No Face to Face contact with customers
Advocates are in a call center environment and serve as the first point of contact by answering inbound calls from customers. Our customers are calling in regards to their Employee Assistance Program/Behavioral Health, Substance Abuse benefits, or claims inquires. Responsibilities include but are not limited to:
Multi-tasking; listening, typing, taking notes, maneuvering through different systems we utilize, payingattention to the queue, etc. Registering customers in the intake system, opening case files for documenting
Ability to deescalate callers and being able to appropriately address sensitive issues with callers.
Assisting customers with requests for services, verifying eligibility for the requested service, and addressing other issues complex in nature.
Educating customers with respect to parameters of services and benefits design.
Providing customers with names and phone numbers of nearest clinicians according to contract, clinical specialty, and/or geographic need.
Writing authorizations for the appropriate level of care to insure claims are paid correctly.
Provide timely follow-up calls to customers as needed.
Demonstrate an awareness and understanding of the responsibilities and workflows of the various departments within the business unit, other areas within Cigna, and matrix partners.
Participating in staff meetings and in-service seminars.
Completing additional tasks and projects as assigned.
Monitoring and following daily schedule as assigned.
Consistently is ready to take callsatthe start of their shift and manages their daily scheduled as assigned by the resource planning team.
Responsible for meeting Quality Score of 92% or greater each month