Client Quality Auditor, Lead Representative - Remote Job at The Cigna Group
As a Client Quality Auditor, Lead Representative you would be responsible for verifying the accuracy and compliance of a certain business transactions against internal operational standards and regulatory requirements. An auditor is responsible for communicating areas of non-compliance and inaccuracies to the appropriate business units to ensure prompt remediation and resolution of any findings identified. This is an excellent opportunity to grow your skills in health plan administration, interact with many levels of leadership, have autonomy and work life balance on this team, and have direct influence in positively impacting client and customer satisfaction.
How you’ll make an impact in this role:
Perform audits to ensure analyst installing the client’s accounts are in accordance to Cigna policies, procedures and client requirements
Manage audit activity assigned, meeting all key deliverables inclusive of expected turnaround times
Document findings in the quality repository, ensuring documentation is clear and concise
Identify and recommend improvements in department processes and procedures and assist in the development of audit guidelines and resource materials
Work fluidly with team members and business partners to facilitate customer-centric solutions
Actively engage in quality initiatives to address error trends and process improvement
Problem Solving: Look beyond the obvious and don't stop at the first answers
Courage: Provide current, direct, complete, and "actionable" positive and corrective feedback to others
Learning and Applying solutions quickly when facing issues
Customer Focus: Be dedicated to meeting the expectations and requirements of internal and external customers
Dealing with Ambiguity: decide and act without having the total picture
Qualifications needed to be successful:
High School Diploma or GED
2+ years customer service experience required
1+ years of experience in an Auditor role required, specifically Claims, Customer Service, Grievance, Eligibility, or Provider preferred, 2+ years’ experience preferred
Health plan and benefit administration experience preferred
Ability to function in a production environment and deliver high quality results; DPL experience a plus
Availability to support overtime and flexibility with OT during high peak periods
Ability to utilize multiple platforms and leverage multiple resources
Ability to manage multiple priorities and deadlines
Ability to work remotely and independently
Business acumen, and the ability to communicate clearly and with brevity to multiple levels of leadership
Strong attention to detail, analytical and organizational skills
Working knowledge of Microsoft Office applications
Excellent verbal and written communication skills
The schedule for this role is expected to be primarily Monday – Friday within normal business hours, as business needs dictate.
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 22 - 34 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.
We want you to be healthy, balanced, and feel secure. That’s why 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) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group .
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 require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com 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.
Please Note :
www.epokagency.com is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, www.epokagency.com provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, Site.com is the ideal place to find your next job.
How you’ll make an impact in this role:
Perform audits to ensure analyst installing the client’s accounts are in accordance to Cigna policies, procedures and client requirements
Manage audit activity assigned, meeting all key deliverables inclusive of expected turnaround times
Document findings in the quality repository, ensuring documentation is clear and concise
Identify and recommend improvements in department processes and procedures and assist in the development of audit guidelines and resource materials
Work fluidly with team members and business partners to facilitate customer-centric solutions
Actively engage in quality initiatives to address error trends and process improvement
Problem Solving: Look beyond the obvious and don't stop at the first answers
Courage: Provide current, direct, complete, and "actionable" positive and corrective feedback to others
Learning and Applying solutions quickly when facing issues
Customer Focus: Be dedicated to meeting the expectations and requirements of internal and external customers
Dealing with Ambiguity: decide and act without having the total picture
Qualifications needed to be successful:
High School Diploma or GED
2+ years customer service experience required
1+ years of experience in an Auditor role required, specifically Claims, Customer Service, Grievance, Eligibility, or Provider preferred, 2+ years’ experience preferred
Health plan and benefit administration experience preferred
Ability to function in a production environment and deliver high quality results; DPL experience a plus
Availability to support overtime and flexibility with OT during high peak periods
Ability to utilize multiple platforms and leverage multiple resources
Ability to manage multiple priorities and deadlines
Ability to work remotely and independently
Business acumen, and the ability to communicate clearly and with brevity to multiple levels of leadership
Strong attention to detail, analytical and organizational skills
Working knowledge of Microsoft Office applications
Excellent verbal and written communication skills
The schedule for this role is expected to be primarily Monday – Friday within normal business hours, as business needs dictate.
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 22 - 34 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.
We want you to be healthy, balanced, and feel secure. That’s why 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) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group .
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 require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com 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.
Please Note :
www.epokagency.com is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, www.epokagency.com provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, Site.com is the ideal place to find your next job.