Prior Authorization Representative - Evernorth - Remote

Location: Northern

** Prior Authorization Representative (PAR)

Job Description
**** Role Summary
** The Prior Authorization Representative (PAR) reviews and responds to phone and/or fax inquiries from members and/or health care professionals and assists them with medication prior authorizations.  
* In this role, system documentation is reviewed, and information is provided in a straightforward, empathetic manner.

* Prior authorization is a process to determine if a prescribed medication is covered by a member’s current health plan.
** Responsibilities*
* * Respond primarily to phone inquiries from members, providers and/or pharmacies. (Fax inquiries may be part of the role.)
* Facilitate prior authorization requests.
* Utilize multiple applications to obtain information.
* Follow standard operating procedures (i.e., dept/corporate documentation, HIPAA regulations etc.) to provide accurate information and outcome.
* Pro- actively research and resolve issues, seeking assistance as needed.
* Maintain accurate and complete documentation of inquiries.
* Work collaboratively with others to ensure best practices are applied.
* Understand and strive to meet/exceed call center and other business metrics.
* Provide excellent and consistent customer service.
* Attend training classes as assigned.
* Work on tasks or projects as assigned.
** Qualifications
* ** High School Diploma / GED
* 1+ years call center customer service experience
* Excellent customer service and communication skills
* Strong organizational skills
* Computer skills; including intermediate proficiency in Microsoft Outlook, working knowledge of Windows and the ability to easily navigate across multiple screens and applications.
* Healthcare background preferred.
* Ability to remain calm and helpful, even when dealing with difficult situations.
* Flexibility to support extended hours and overtime as determined by business needs to meet customer expectations.
* Able to attain 100% attendance throughout training/on the job training and maintain excellent attendance beyond.
* Must live in a DoD SCA County
* * Must work any schedule between hours of operation which can range between (but not limited to) 7:00am – 10:00pm Eastern time, Monday through Friday.*
* * Training schedule may vary, however typically 9:00 am – 5:30 pm Easter time, Monday through Friday for 4 weeks and an additional 2 weeks for on-the-job training.
*** Work from Home Requirements
*** Reliable high-speed broadband internet,
** hard-wired
** connection (10 Mbps for download / 5 MBPS for upload)
* Quiet and private space designated for work without interruption.  
** Role Competencies
** ACTION ORIENTED    INTERPERSONAL SAVVY   INSTILLS TRUST   CUSTOMER FOCUS   PLANS AND ALIGNS   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 10

Mbps download/5

Mbps upload.

For this position, we anticipate offering an hourly rate of 17.75 - 26 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, .