Prior Authorization Representative - Evernorth - Remote

Cigna Healthcare•Pennsylvania Work at Home, IN

2d•$18 - $26•Remote

About The Position

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. Prior authorization is a process to determine if a prescribed medication is covered by a member’s current health plan.

Requirements

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.
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 Easter time, Monday through Friday for 4 weeks and an additional 2 weeks for on-the-job training.
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.

Nice To Haves

Healthcare background preferred.

Responsibilities

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.