Cigna Healthcare is seeking a friendly, compassionate, and dedicated Member Services Representative to join our team remotely. In this vital role, you will be the first point of contact for our members, providing exceptional customer service and helping them navigate their healthcare needs. As a Fully Remote Member Services Representative, you will support our members with inquiries related to their health plans, benefits, claims, and other healthcare services.

If you are passionate about delivering excellent service, solving problems, and making a meaningful difference in people healthcare experiences, this is the perfect opportunity for you!

Key Responsibilities:

• Member Support: Answer inbound calls and respond to member inquiries, providing accurate information about health plan benefits, claims status, coverage options, and network providers.
• Problem Resolution: Address and resolve member issues and concerns with professionalism, ensuring a positive experience for each member while adhering to company policies.
• Claims Assistance: Help members understand their claims by explaining billing statements, providing updates on claim status, and assisting with the appeals process when needed.
• Benefit Education: Educate members about their healthcare benefits, including coverage details, co-pays, out-of-pocket expenses, and how to utilize their benefits effectively.
• Enrollment Assistance: Assist members with the enrollment process, changes to their plans, and provide information on plan options during open enrollment periods.
• Documentation & Record Keeping: Accurately document member interactions, ensuring all cases are tracked, follow-ups are completed, and any issues are escalated as needed.
• Cross-Department Collaboration: Work with other internal departments, such as claims, customer service, and provider relations, to ensure members receive timely and accurate information.
• Customer Satisfaction: Maintain a high level of professionalism and empathy to ensure that every member receives the highest quality service and feels supported in their healthcare journey.

Required Qualifications:

• High school diploma or equivalent (Associate or Bachelor degree preferred).
• 1+ years of customer service experience, preferably in the healthcare or insurance industry.
• Strong communication skills with the ability to explain complex healthcare information in an easy-to-understand way.
• Empathetic and patient, with a desire to help others and make a positive impact.
• Ability to work independently in a fully remote environment, managing time effectively and meeting performance goals.
• Proficient in Microsoft Office Suite and experience using customer service or CRM tools.
• Strong problem-solving and organizational skills with attention to detail.

Preferred Qualifications:

• Previous experience in a member services or healthcare support role.
• Familiarity with health insurance terms, benefits, and claims processes.
• Bilingual skills are a plus (Spanish, Mandarin, etc.).

Why Cigna?

• Fully Remote Work: Enjoy the flexibility and convenience of working from home while helping members navigate their healthcare needs.
• Career Growth: Cigna offers extensive opportunities for career development, including training programs and potential for advancement.
• Comprehensive Benefits: We offer a competitive benefits package, including healthcare, dental, vision, retirement plans, wellness programs, and more.
• Inclusive and Supportive Culture: Cigna is committed to fostering a diverse, inclusive, and supportive workplace where employees feel valued and empowered.

How to Apply:If you are passionate about helping people and providing exceptional customer service in the healthcare space, apply now to become a Member Services Representative with Cigna Healthcare. Join us and make a difference by providing vital support to our members!