The Cigna Group Hiring for Grievance Customer Service Lead Representative – Cigna Healthcare – Remote at Hartford, CT Full Time

At Cigna Healthcare, we invest in you. As a Grievance Customer Service Lead Representative, you are offered extensive, paid hands on training, a supportive post-training environment to pave your success. Cigna Healthcare encourages career development and offers continuing educational resources internally and externally to help you in your career advancement.

Role Summary

In this pivotal role, Customer Service Lead Representative respond to complex inquiries regarding benefits, billing, eligibility, coverage and other related information and provide solutions for customers, clients and health care professional via phone and email.

Creative problem solving, critical thinking and empathy skills are essential. Professional interaction, active and passive listening skills and the ability to utilize computer- based resources in a highly effective manner to educate and provide accurate responses to customer inquiries is crucial for success in the role, along with the innate ability to be compassionate and empathetic when appropriate when handling complex customer inquiries.

Customer Service Lead Representative respond to customer, health care professional and client inquiries primarily regarding:

Eligibility to receive benefits associated with their individual or company sponsored health insurance plan

Determination of out of pocket costs related to medical or dental office visits, prescription medications, inpatient and outpatient procedures, diagnostic imaging for treatment of injuries, medical equipment and preventive care

Understanding of payments and claims related to office and hospital visits and medical and dental procedures, and thoroughly explaining how customer benefits are applied to costs associated with these visits and procedures

Finding an in-network primary care or specialist doctor in a geographical area or specialty

Education on disease management programs and healthy living programs personalized to the customer’s medical condition or health improvement goals

Customer Service Lead Representatives are measured on:
Direct feedback from customer and health care professionals via post call surveys, which include:

The ability of the customer service associate to resolve their inquiry

Their satisfaction with the overall experience while they spoke with the associate

The level of effort that the customer experienced in resolving their inquiry

Internal quality assessments that measure how accurately and efficiently the customer service associate responded to the inquiry

Qualifications:
Associate degree or bachelor’s degree preferred

1+ years’ experience analyzing and solving customer problems required; Intermediate proficiency in Microsoft Office Suite; high level capacity to multitask independently and on a computer

Medicare Grievances experience preferred.

Knowledge of Medical Terminology a PLUS

Excellent written and oral communication skills

Proven ability to work independently as well as a productive member of a team

Exceptional organizational and time-management focus

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 19 – 29 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 Cigna Healthcare

Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. 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.