About The Position

The Customer Service Associate Representative answers phone inquiries from participants, clients, and providers about group health benefits and claims payments. Responsibilities also include research on claims and assisting team members as needed. Since 1981, Allegiance by Cigna Healthcare has specialized in the administration of medical benefits, offering core services such as claims processing, customer service, utilization management, and case management. Backed by a unique high-touch approach to both member and client service, Allegiance supports and administers some of the nation's most innovative approaches to Health Plan benefits. 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.

Requirements

  • Minimum Education: High school graduation or GED required.
  • Minimum Experience: Basic computer and customer service experience required.
  • Excellent oral and written communication skills required.
  • PC skills, including Windows, Word and Adobe Acrobat. Ability to adapt to software changes.
  • Typing ability of 45 wpm.
  • Excellent listening skills.
  • Basic mathematical skills.
  • High level of interpersonal skills to work effectively with others.
  • Ability to organize and recall large amounts of detailed information.
  • Ability to read, analyze and interpret benefit summary plan descriptions, insurance documents and regulations.
  • Ability to project a professional image and positive attitude in any work environment.
  • Ability to comply with privacy and confidentiality standards.
  • Ability to be flexible, work under pressure and meet deadlines.
  • Ability to analyze and solve problems with professionalism and patience.
  • 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.

Responsibilities

  • Answer telephone calls from plan participants, group contacts, and providers pertaining to benefits and claims inquiries.
  • Provide clear and accurate responses to requests for information.
  • Document all calls into Chronolog (by typing in highlights of the conversation) for future referral.
  • Return messages left in designated voice mailboxes.
  • Read and interpret plan documents for numerous clients, review new documents and amendments as added.
  • Meet personally with clients as necessary to assist with questions pertaining to their health benefit plan.
  • Assist team members as requested.
  • Log faxed claims (type information faxes received in Chronolog).
  • Return misdirected claims to appropriate provider as received.
  • Assist members with website.
  • Meet or exceed company standards for production and quality.
  • Contribute to the daily workflow with regular and punctual attendance.
  • Assist with claim information research and identification.
  • Assist with provider record maintenance as assigned.
  • Index claim and correspondence batches as assigned.
  • Perform assigned duties for specific client groups as needed.
  • Assist with employee training and cross-training as needed.
  • Research and write up refunds as assigned.
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