Remote Prior Authorization Representative Express Scripts Jobs in Princeton, NJ

The Cigna Group is a global Health Service company dedicated to helping people improve their health and vitality. We seek dedicated, compassionate, and empathetic Customer Service Representatives to join our team who are genuinely interested in helping people at some critical points of their lives. The Call Center Customer Service Representative represents the company, and our people make all the difference in our success.

RESPONSIBILITIES

• Answer inbound calls from members, providers, and pharmacies with questions about Pharmacy Benefit Services(PBS) benefits, mail-order pharmacies, or Medicare.

• Take calls back-to-back while toggling through several applications on multiple screens.

• Attend 100% of trainings and the first 90 days of employment.

• Update conversion requests and provide shipment status to members

• Facilitate transition of requested medications to home delivery

• Advocate for the member patient by placing phone calls, fax or other means to physician's office to obtain prescriptions and forward to pharmacy for fulfillment

• Obtain new prescriptions from physician's office and record approval status

• Service incoming calls from doctors' offices

• Ensure accurate and complete documentation is entered into the appropriate systems for all contacts (internal/external) to maintain the quality of the home delivery process, document HIPAA compliance and reduce potential legal concerns

• Resolve questions and/or issues that may be preventing shipment of an order

• Uphold quality and productivity standards on all transactions

• The customer service representatives must ensure complete and accurate documentation into the appropriate systems to maintain quality and to meet regulatory requirements.

• Use active listening skills when the members express concerns about medication coverage or costs and offer the members options for a starting coverage review to meet regulatory requirements

• Understand and strive to meet or exceed call center metrics while providing excellent consistent customer service

• You will learn and need to demonstrate understanding of call handling which includes compliance expectations and system navigation through several applications

• Enjoy a work-from-home lifestyle where you can virtually connect with coworkers and customers.

Here's a little more on how you'll make a difference:

• Help patients understand their pharmacy benefits better. Use the knowledge you gain from training, your problem-solving skills and support from your team answer patient calls effectively.

• Help us keep track of our patient interactions. While on calls, use your expert listening skills to get to the heart of a patient's question quickly and document all interactions in real-time.

• Ensure patients are equipped with the best advice. Identify and empathetically address patient concerns and, if necessary, escalate appropriately

QUALIFICATIONS

• High School diploma or equivalentrequired

• At least 2+ years of relevant experience- Healthcare and/or Call Center Preferred

• A dedicated workspace with no distractions is required

• Tech Savvy- Strong computer skills including Microsoft Office

• Strong organization skills, written, and verbal communication skills

• Ability to provide exceptional listening and customer service skills; remain calm and helpful even when dealing with difficult callers

• Ability to adapt in a dynamic work environment, learn quickly, solve problems and make decisions

• Foster teamwork and partnership with cross-functional departments to resolve issues and improve customer experience

• Ability to work a flexible schedule including Night and/or weekends

Schedule

Training: 9:00 AM - 5:30 PM EST - M-F (8 Weeks).

Post Training: Schedules may range between 7:00 AM EST - 12:00 AM EST 7 days a week (Schedules may be subject to change based on business needs)

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 17.75 - 19 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.

At The Cigna Group, 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), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year, paid holidays, and leaves of absence. For more details on our employee benefits programs, click here.

About The Cigna Group

Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we're dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. 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 need a reasonable accommodation to complete the online application process, please email seeyourself@thecignagroup.com for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.

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.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.