This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more.

Role Description

The Customer Service Associate Representative provides support to participants, clients, and providers by answering inquiries related to group health benefits and claims payments. The role also includes researching claims, documenting interactions, and assisting team members as needed.

Essential Job Functions

• Answer telephone calls from plan participants, group contacts, and providers regarding benefits and claims.
• Provide clear, accurate, and timely responses to information requests.
• Document all calls in Chronolog by summarizing key points of each conversation.
• Return messages from designated voicemail boxes.
• Read, interpret, and apply plan documents, new amendments, and updates for multiple clients.
• Meet with clients as needed to assist with questions about their health benefit plans.
• Support team members and cross‑functional partners as requested.
• Log faxed claims and enter fax information into Chronolog.
• Return misdirected claims to the appropriate provider.
• Assist members with navigating the website.
• Meet or exceed company standards for quality and production.
• Maintain punctual and reliable attendance.
• Support claim information research and identification.
• Assist with provider record maintenance tasks.
• Index claims and correspondence batches.
• Complete responsibilities assigned for specific client groups.
• Aid in employee training and cross‑training.
• Research and prepare refund documentation.

Quality Assurance Measurements

• Consistently meet or exceed company standards for production, quality, and audit performance.

Qualifications

• High school diploma or GED required.
• Basic computer and customer service experience.
• Excellent verbal and written communication skills.
• Proficiency with PC tools including Windows, Word, and Adobe Acrobat; ability to learn new software.
• Minimum typing speed of 45 wpm.
• Strong listening skills and attention to detail.
• Basic mathematical competency.
• High interpersonal skills and the ability to work collaboratively.
• Ability to organize and recall large amounts of detailed information.
• Capability to read, analyze, and interpret benefit plans, insurance documents, and regulations.
• Professional attitude with the ability to project a positive image in all work environments.
• Commitment to privacy and confidentiality standards.
• Flexibility to work under pressure and meet deadlines.
• Strong problem‑solving abilities with professionalism and patience.

Company Description

Since 1981, Allegiance by Cigna Healthcare has specialized in administering medical benefits, including claims processing, customer service, utilization management, and case management. With a high‑touch approach to member and client service, Allegiance supports some of the nation’s most innovative health benefit strategies.

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.