[Hiring] Prior Authorization Representative @Cigna Healthcare

Role Description

The Prior Authorization Representative (PAR) reviews and responds to phone and/or fax inquiries from members and/or health care professionals and assists them with medication prior authorizations. In this role, system documentation is reviewed, and information is provided in a straightforward, empathetic manner.

• Respond primarily to phone inquiries from members, providers and/or pharmacies. (Fax inquiries may be part of the role.)
• Facilitate prior authorization requests.
• Utilize multiple applications to obtain information.
• Follow standard operating procedures (i.e., dept/corporate documentation, HIPAA regulations etc.) to provide accurate information and outcome.
• Pro-actively research and resolve issues, seeking assistance as needed.
• Maintain accurate and complete documentation of inquiries.
• Work collaboratively with others to ensure best practices are applied.
• Understand and strive to meet/exceed call center and other business metrics.
• Provide excellent and consistent customer service.
• Attend training classes as assigned.
• Work on tasks or projects as assigned.

Qualifications

• High School Diploma / GED
• 1+ years call center customer service experience
• Excellent customer service and communication skills
• Strong organizational skills
• Computer skills; including intermediate proficiency in Microsoft Outlook, working knowledge of Windows and the ability to easily navigate across multiple screens and applications.
• Healthcare background preferred.
• Ability to remain calm and helpful, even when dealing with difficult situations.
• Flexibility to support extended hours and overtime as determined by business needs to meet customer expectations.
• Able to attain 100% attendance throughout training/on-the-job training and maintain excellent attendance beyond.
• Must live in a DoD SCA County
• Must work any schedule between hours of operation which can range between (but not limited to) 7:00am – 10:00pm Eastern time, Monday through Friday.
• Training schedule may vary, however typically 9:00 am – 5:30 pm Eastern time, Monday through Friday for 4 weeks and an additional 2 weeks for on-the-job training.

Requirements

• Reliable high-speed broadband internet, hard-wired connection (10 Mbps for download / 5 MBPS for upload)
• Quiet and private space designated for work without interruption.

Benefits

• Hourly rate of 17.75 - 26 USD / hourly, depending on relevant factors, including experience and geographic location.
• Eligible to participate in an annual bonus plan.
• Comprehensive range of benefits, including medical, vision, dental, and well-being and behavioral health programs.
• 401(k) plan.
• Company paid life insurance.
• Tuition reimbursement.
• A minimum of 18 days of paid time off per year.
• Paid holidays and leaves of absence.

Company Description

At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients.