Reporting to the Integrated Health Team supervisor, the Care Coordinator is responsible for ensuring customer-centric and cost-effective services to support our clients and members. This individual is the liaison between our customers, healthcare providers, and our non-clinical/clinical teams.
Communicates both internally and externally to provide and verify information; to explain processes; and to answer questions regarding products and services (verbal and written)
Accesses multiple systems to collect, enter, and verify clinical and non-clinical data.
Makes outbound calls to healthcare providers to request needed information in order to authorize specific services.
Assists customers with choosing a quality health care provider within our network.
Adheres to and enforces quality assurance standards, and all case management policies and procedures.
Collaborates with diverse departments such as Customer Service, Client Management, and Fraud, Waste and Abuse in order to deliver customer centricity and service excellence.
Negotiates rates with, and issue guarantees of payment to providers rendering services to our members.
This role will be second shift from 1pm - 9pm EST and will require the candidate to be in the office.
Multilingual – preference Spanish or another language
3-5 years’ experience in healthcare administration preferred.
Strong time management, organization, research, analytical, and customer service skills
Knowledge of medical health terminology preferred
Excellent oral and written communication skills as well as attention to details
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 an accommodation based on your physical or mental disability please email: SeeYourself@cigna.com. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.