Note: The job is a remote job and is open to candidates in USA. The Cigna Group is a global health services company dedicated to improving the health and vitality of the people it serves. The Customer Service Representative will support members, providers, and pharmacies with pharmacy benefit, mail-order pharmacy, and Medicare inquiries, while documenting interactions accurately and maintaining HIPAA and regulatory compliance. The role also involves facilitating medication transitions, resolving shipment issues, and delivering empathetic customer service in a remote call-center environment.
Responsibilities
- Answer inbound calls from members, providers, and pharmacies with questions about Pharmacy Benefit Services(PBS) benefits, mail-order pharmacies, or Medicare
- Take calls back-to-back while toggling through several applications on multiple screens
- Attend 100% of trainings and the first 90 days of employment
- Update conversion requests and provide shipment status to members
- Facilitate transition of requested medications to home delivery
- Advocate for the member patient by placing phone calls, fax or other means to physician’s office to obtain prescriptions and forward to pharmacy for fulfillment
- Obtain new prescriptions from physician’s office and record approval status
- Service incoming calls from doctors’ offices
- Ensure accurate and complete documentation is entered into the appropriate systems for all contacts (internal/external) to maintain the quality of the home delivery process, document HIPAA compliance and reduce potential legal concerns
- Resolve questions and/or issues that may be preventing shipment of an order
- Uphold quality and productivity standards on all transactions
- The customer service representatives must ensure complete and accurate documentation into the appropriate systems to maintain quality and to meet regulatory requirements
- Use active listening skills when the members express concerns about medication coverage or costs and offer the members options for a starting coverage review to meet regulatory requirements
- Understand and strive to meet or exceed call center metrics while providing excellent consistent customer service
- You will learn and need to demonstrate understanding of call handling which includes compliance expectations and system navigation through several applications
- Enjoy a work-from-home lifestyle where you can virtually connect with coworkers and customers
- Help patients understand their pharmacy benefits better. Use the knowledge you gain from training, your problem-solving skills and support from your team answer patient calls effectively
- Help us keep track of our patient interactions. While on calls, use your expert listening skills to get to the heart of a patient’s question quickly and document all interactions in real-time
- Ensure patients are equipped with the best advice. Identify and empathetically address patient concerns and, if necessary, escalate appropriately
Skills
- High School diploma or equivalent required
- A dedicated workspace with no distractions is required
- Tech Savvy- Strong computer skills including Microsoft Office
- Strong organization skills, written, and verbal communication skills
- Ability to provide exceptional listening and customer service skills; remain calm and helpful even when dealing with difficult callers
- Ability to adapt in a dynamic work environment, learn quickly, solve problems and make decisions
- Foster teamwork and partnership with cross-functional departments to resolve issues and improve customer experience
- Ability to work a flexible schedule including Night and/or weekends
- At least 2+ years of relevant experience- Healthcare and/or Call Center Preferred
Benefits
- This role is also anticipated to be eligible to participate in an annual bonus plan.
- Starting on day one of your employment, you’ll be offered medical, vision, dental, and well-being and behavioral health programs.
- 401(k)
- Company paid life insurance
- Tuition reimbursement
- A minimum of 18 days of paid time off per year
- Paid holidays
- Leaves of absence
- Work-from-home lifestyle
Company Overview