Job Summary:

The Provider Advocate role is a customer service position within a call center that supports the Evernorth Behavioral Health provider network. Provider Advocates are responsible for handling non-clinical inbound calls from providers and their staff regarding mental health and substance use disorder services. Advocates guide and assist providers and their staff to help them work with Evernorth more effectively and reduce administrative issues.

The types of calls a Provider Advocate services may include but are not limited to: inquiries about eligibility, benefits, claim processing, provider demographic updates, or provider contracting. Due to the wide variety of call types, several applications are required to service these inquiries, and multiple applications are often needed within the same call. Independent problem solving, multitasking, and technical savvy are essential in order to be able to carry out the responsibilities of this role. Calls must be serviced in a helpful and professional manner.

The work environment for this position is structured. Each employee is scheduled a thirty minute lunch and two fifteen minute breaks per day. This is to ensure adequate phone coverage throughout the day to be able to handle the incoming call volumes.

Must be a current contractor with Cigna, Express Scripts, or Evernorth. Evernorth is a new business within the Cigna Corporation. This role is WAH/Flex which allows most work to be performed at home. Employees must be fully vaccinated if they choose to come onsite.

Responsibilities:

The primary responsibility of this role is to answer inbound calls from providers and their support staff. The majority of the day will be spent answering these calls from a queue.

Within a call an advocate may:

• Communicate eligibility, benefits, and authorization requirements to providers for their customers who have Cigna or Evernorth coverage


• Write authorizations to ensure claims are paid correctly


• Interpret claims information using multiple claim platforms, assist the provider with any claim processing issues, or send claims back for reconsideration if necessary


• Educate the provider regarding billing procedures, or when there are billing issues


• Provide follow-up on issues by making outbound calls when necessary


• Send resources to providers via email


• Submit a complaint on the provider's behalf


• Independently problem-solve to ensure accurate information is given, and exceptional customer service and first call resolution is achieved

Qualifications:

• Bachelor's Degree required.


• Customer Service experience is preferred.

• Independent problem solving skills


• Ability to maintain a professional and positive image to external customers


• Candidate must possess superb interpersonal communication skills


• Effective listening and organizational skills, with the ability to manage multiple tasks


• Intuitive technical capabilities with the ability to quickly understand and apply working knowledge on several proprietary systems


• Ability to type effectively and have strong PC skills


• Ability to adapt well to change and stay up-to-date with frequent workflow changes

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 18 - 27 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 .

About Evernorth

Evernorth, Cigna Corporation's health services segment, exists to elevate health for all. We're building on our legacy and redefining health care as we know it. Unbiased in how we think, we create without limitation. We partner without constraints, deliver value differently and act in the interest of humanity. Solving across silos, closing gaps in care, and empowering clients, customers, and people everywhere to move onward and upward. When you work with us, you'll be empowered to solve the problems others don't, won't or can't. Join us. What difference will you make?

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: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.

Cigna 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.