[Hiring] Prior Authorization Representative @The Cigna Group

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.