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Care Associate, Clinical Services
4 months ago
The primary purpose of the Care associate position is to provide a variety of departmental support functions that contribute to the overall efficiency of the Case Management Department. The most important of these functions are communication, customer service, data entry, record retrieval and the preparation, privacy and maintenance of all records and other duties as assigned.
Main Duties / Responsibilities
Responsible for authorization data collection and/or data entry into computer system from incoming calls or faxes.
support the daily functions and Assign tasks to case manager
Answers inquires, gathers information, resolves routine matters, and responds to minor complaints or problems received through inbound phone queue.
May maintain documentation for regulatory review, participate in education of members / providers regarding plan benefits, and make referrals to other departments.
May interact with other departments and external vendors.
Will complete authorization request from providers via phone call, incoming fax or provider portal.
Will distribute request to appropriate Clinician. Will work closely with member services, Clinician, and case manager.
Additional assignments as requested.
Education/Professional Qualifications/Experience Required
High School Diploma or equivalent.
At least 2 years of experience in health services, call center and/or managed care environment.
Skills
Knowledge of managed care and/or medical management and medical terminology.
Intermediate skills in word processing, data entry of medical information/ terminology and telephone skills.
Willingness to learn and be a team player
Working knowledge of Microsoft Office Programs
Critical thinking skills
The ability to work with employees at all levels
Strong interpersonal communication and customer service skills with the ability to motivate others
The ability to work both independently and as a part of a team with enthusiasm, initiative and creativity
Excellent skills in all Microsoft Office Programs including Word, PowerPoint, Publisher and Excel
Ability to interpret data and translate findings into business opportunities
Ability to develop relationships across all levels of the Company, as well as externally
Excellent communication skills in both written and spoken English and Chinese
Required Core Values & Behaviors
Growth mindset
Collaboration & communication
Ownership & accountability
Customer Focus
About The Cigna Group
Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.