Health Care Navigator - Cigna - Remote

Are you the type of person that enjoys helping others? If you have a background in customer service or experience in healthcare, specifically benefits and claims processing, you might be the perfect fit to join our team as a Care Navigator Representative.

As a Care Navigator, you'll proactively support customers and help them understand their Cigna Healthcare medical plans and educate customers on Evernorth programs and services.

You'll do this by actively listening, address customer needs, then offer programs and solutions from their plan.

You'll be expected to go above and beyond with each call, but you won't be alone.

You'll be on a team of highly trained and skilled professionals that will be there to help you answer difficult questions and offer solutions.

YOUR RESPONSIBILITIES:


* Provide high level of service for inbound customer calls about their medical benefits by direct messaging, plus you may also provide digital chat support to customers.


* Listen and understand customers unique needs, seeking more information through probing questions with the goal of offering programs and services that apply to their past, current or future needs.


* Have a strong understanding of the full suite of benefit and programs, and you'll connect with other teams (Medical benefit, Clinical, Social Work, etc.) appropriately.


* Investigate and resolves escalations, determine barriers to care, and help to resolve complaints by reviewing policies and procedures.

When scripts or instructions are not available, you'll determine the best solution and guide the customer.


* Proactively offer outreaches to providers, doctor or vendors as needed to bring next steps into action or resolution removing effort from the customer.

You may serve as the liason between customers, health plans, services centers, etc.


* Takes ownership and provides timely follow-up on any takeaway from customer interactions.

i.e., Evernorth app tickets, prior authorizations pending, findings from claim discrepancies, etc.


* Assists customer with the Evernorth app including but not limited to 1) Helping download, register, and log into the app; 2) Inform of all app features and highlight navigation steps to find vendor offerings; 3) Educate on Wellness Rewards and value propositions; 4) Troubleshoot app & provide follow-up on tickets submitted for resolution.


* Be highly coachable and open to feedback to improve customer experience driving a consistently accurate quality of service.

QUALIFICATIONS:


* Associate degree or higher required and/or 4+ years' work experience in healthcare orcustomer servicefield.


* Ability to actively listen to understand current needs and complexities while identifying next steps & potential future needs.


* Excellent written and verbal interpersonalcommunication skills.


* Adept with Knowledge Exchange & initiative-taking resource utilization.


* Confidence with technology, innovational progress, and ...