Cigna Case Coordinator (National Authorization Team) in Fenton, Missouri

Description:

Work hours REQUIRED: 10:30am - 7:00pm CST

The primary purpose of this position is to coordinate Fast Cert authorizations for providers for CBH East, TruCare, Care Allies and Qani books of business. NAT CC’s communicate with Individual and Facility Providers regarding authorization requests for all levels of care( IP, RES, PHP,IOP, OP) for mental health and substance abuse services on behalf of our customers.

Provide exceptional customer service, collaborating closely with inpatient Care Coordinators, Care Managers, facilities and individual providers to ensure proper access and utilization of benefits.

RESPONSIBILITIES:

  • Responsible for validating HIPAA, verifying eligibility, quoting benefits, providing referrals, and completing authorization and handoff process.
  • Utilize workflows to efficiently and accurately make nonclinical decisions and complete authorization and/or handoff process.
  • Participate in implementing tasks related to increasing holistic approach to management of customer cases including meaningful engagement, aftercare follow-up planning and integration of services with matrix partners.
  • Answering calls as they come in the queue.
  • Handing cases off when they do not meet Fast Cert Authorization criteria
  • Processing electronic auth requests
  • Answering and processing provider calls for Cigna East and TruCare
  • Answering Care Allies Customer and Provider calls and processing Care Allies Fast Cert Authorizations
  • Integrating with medical when appropriate through referrals.
  • Researching complicated cases, i.e. eligibility, escalated cases,etc
  • Participating in assigned work groups and opportunities for stretch assignments
  • Attending and participating in team meetings.

Qualifications:

  • Bachelor’s degree, with a minimum of one year of related work experience
  • Strong interpersonal skills with capacity to project warmth and empathy
  • Effective listening & organizational skills
  • Detail oriented
  • Experienced and skilled in working with multiple PC systems and applications, efficient in responding to requests while simultaneously maneuvering various computer screens among multiple systems while able to meet metrics and adhere to IEX scheduling requirements.
  • Proven customer service skills

Primary Location: Eden Prairie-Minnesota

Other Locations: United States-Missouri-Fenton, United States-Texas-Plano

Work Locations: 11095 Viking Dr Eden Prairie 55344

Job: Med Mgt--Case Management

Schedule: Regular

Shift: Standard

Employee Status: Individual Contributor

Job Type: Full-time

Job Level: Day Job

Travel: No

Job Posting: Jun 13, 2018, 3:45:53 PM

Qualified applicants will be considered for employment without regard to age, race, color, religion, national origin, sex, sexual orientation, gender identity, disability, veteran status. Need an accommodation? Email: SeeYourself@cigna.com