Customer Service Representative

Job Description Summary
Delivers straightforward administrative and/or other basic business services in Customer Service. Receives requests by mail, telephone, or in person regarding insurance claims/policies. Responds to inquiries from policy holders, providers and/or others for information and assistance. Performs research to respond to inquiries and interprets policy provisions to determine most effective response. Mails or routes claim forms and supporting documentation to various units for final processing. Position typically requires excellent interpersonal skills, ability to understand and interpret policy provisions. Independently responds to inquiries, grievances, complaints or appeals ranging from routine to moderate complexity. Issues tend to be routine in nature. Good knowledge and understanding of Customer Service and business/operating processes and procedures. Works to clearly defined procedures under close supervision.

What are your main responsibilities?

• You are responsible for the client communication for designated account relationships and Contracts.
• You are required to response to the client on timely manner providing full and accurate information in one go.
• Handle calls and e-mails and respond to simple and complex inquiries regarding eligibility, cards status, envoy registration/navigation, policy benefits, issue certificates of insurance, claims status and other related information and provide solutions for customers and clients.
• Receives requests by mail, telephone, or in person regarding insurance claims/policies. Responds to inquiries from policy holders, clients, brokers and/or others.
• Performs research to respond to inquiries and interprets policy provisions to determine most effective response.
• Mails or routes claim forms and supporting documentation to various units for final processing.
• Excellent interpersonal skills, ability to understand and interpret policy provisions. Independently responds to inquiries, grievances, complaints, or appeals ranging from routine to moderate complexity.
• May seek assistance with complex customer services issues.

Qualifications

• Must have a diploma or bachelor's degree certificate
• Excellent English written and oral communication skills
• French written and oral skill is a must
• Exceptional organizational and time-management focus
• Independently responds to inquiries, grievances, complaints or appeals ranging from routine to moderate complexity.
• 1+ years of customer service experience analyzing and solving customer problems required; call center experience a plus
• Ability to perform in a high volume, fast paced call center environment
• Proven ability to work independently as well as a productive member of a team
• Intermediate proficiency in Microsoft office suite; high level capacity to multitask independently and on a computer
• Knowledge of medical terminology a plus

Conditions/requirements

• Work in 24 x 7 rotation shifts.
• 5 days a week.
• In split shifts (some hours in the morning and remaining hours in the afternoon or evening) and public holidays

About Cigna Healthcare
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.

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.
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