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Location

Tennessee | United States

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Job description

Behavioral Health Personal Advocate - Remote - Evernorth Health Services Location Remote in Tennessee :

Please Note: A candidate has been pre-identified for this role, however all interested parties are encouraged to apply.

The Personal Advocate position is responsible for representing Cigna Behavioral Health (CBH) to all inbound callers within a call center environment and assuring caller's contact with CBH is positive. Advocates are many times the first encounter customers have with Cigna and thus are responsible for giving a positive first impression. The Advocacy tasks of this position are varied and often complex in nature requiring flexibility and multi-tasking capabilities. Responsibilities may include but are not limited to: educating customers on benefits, eligibility, referrals, non-clinical resources and assessing for potential risk of harm or substance abuse concerns.

This position services calls in a warm and empathetic manner as many of the calls are sensitive in nature. Independent problem solving skills are critical to success within the role along with intelligent judgment of assessing the caller's needs. Based upon the call type and requests advocates should be able to use customer service skills, knowledge of the mental health/substance abuse field and Cigna training to effectively address callers needs in an educational manner. This position is an entry level role with opportunity for growth within the company. Incumbents will utilize telephonic communication the majority of the time with some web, and internal CBH materials to achieve first time resolution for callers.

Responsibilities:

The primary responsibility of the Advocate role is answering calls from customers. The majority of the day will be answering inbound calls from customers looking to access, understand, or utilize services.

Within a call an advocate may:

• Register participants in the intake system and opens case files

• Educate participants on their benefits based upon individual plan design and other clinical or non-clinical resources available

• Conduct an intake as needed to assess for presenting concern and risk of harm or substance abuse concerns

• Provide participants with names and phone numbers of nearest providers
• Multi-task by maneuvering through various computer programs and screens

As needed an advocate may also:

• Write authorizations to ensure claims are paid correctly.

• Provide follow-up calls to participants to ensure correct information is given
• Send eligibility requests to determine effective coverage dates or to verify correct benefits are loaded
• Send complaints to initiate grievance process for customers

On all calls an advocate is responsible for:

• Providing high quality customer service as identified by Advocacy department quality standards

• Using independent problem solving skills to make sound decisions in assessing the needs of the callers by giving accurate information and providing first call resolution

• Understanding the business needs of the role, while balancing the needs of the customer

• Taking an educational approach to ensure callers are able to understand the complexities of accessing care
• Demonstrating a complete awareness and understanding of the responsibilities and workflows of the various departments within Cigna

QUALIFICATIONS:

• Bachelor's degree
• Previous customer service experience or related position
• Superb interpersonal communication
• Effective listening and organizational skills
• Ability to manage multiple tasks, setting priorities where needed
• Independently problem solve, with ability to function without constant supervision
• A demonstrated ability to type effectively; with strong PC skills/word processing experience and ability to learn new computer software systems
• Ability to learn new workflows and tasks quickly
• Ability to work independently and be a team player
• Previous call center environment experience preferred

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.

About Evernorth Health Services

Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives.

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: [email protected] for support. Do not email [email protected] for an update on your application or to provide your resume as you will not receive a response.

The Cigna Group 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.

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