The Cigna Group

Client Services Representative

• Own and support a book of business aligned to the CGHB National Account Segment
• Partner with Sales to build and sustain client relationships
• Own end-to-end service delivery and resolve client and customer needs in a timely and cost-effective manner
• Develop case-level service strategies and customized service solutions for plan administration
• Prioritize tasks and deliverables to achieve timely, high-quality outcomes
• Engage internal matrix partners on escalated service issues involving billing, banking, eligibility, customer service, plan setup and claim payment
• Perform root cause analysis and drive first-contact resolution
• Attend client meetings and provide insights into complex client and customer issues
• Facilitate engagement between Cigna subject-matter experts to execute client service strategy
• Manage issues through end-to-end resolution
• Partner with Sales, Underwriting and Operations on client-specific service strategies, growth opportunities and retail strategies
• Provide routine updates to the Sales account management team on at-risk service issues
• Monitor client health, account metrics and performance guarantees
• Conduct proactive service touchpoints regarding service scorecard/dashboard results
• Provide standard service reports to the account team and client
• Analyze data and trends and present results to the client

Client Service Executive

Billing Specialist

• Drive timely and accurate reimbursement by managing pharmacy claim billing, collections, and follow-up activities
• Resolve denied, rejected, or underpaid claims by identifying root causes and applying corrective strategies
• Interpret explanations of benefits (EOBs) to validate reimbursement accuracy and determine next steps
• Monitor accounts receivable and manage outstanding balances through payer or patient outreach
• Prepare, submit, and track payer appeals within required timeframes
• Evaluate payer rules and reimbursement guidelines to determine whether claims should be corrected, refiled, or appealed
• Identify and correct billing or submission errors impacting reimbursement
• Maintain documentation of collection activity in patient notes and reporting tools
• Partner with teammates and leaders to identify workflow improvements that strengthen efficiency, compliance, and financial performance
• Support CarepathRx within Evernorth Health Services’ Pharmacy and Care Delivery organization

Senior Enrollment/Billing Representative, Home Infusion

Pharmacist

• Interpret physicians’ and prescribers’ prescriptions
• Contact physicians and patients to verify prescription information and expedite order processing
• Consult with patients about medication use and potential drug interactions
• Contact physicians for new and transfer authorization
• Collaborate with physicians to convert prescriptions to generic or preferred drugs when possible
• Track order status and outstanding issues
• Handle customer calls regarding lost orders or dispensing errors
• Maintain daily production, quality, and service levels
• Adjust work priorities and activities to business needs
• Provide oversight and quality assurance to pharmacy technicians
• Verify controlled-substance validity
• Verify prescription information entered by data entry or order entry
• Back up other pharmacists as needed
• Train less experienced pharmacists
• Perform additional duties assigned by management

Staff Pharmacist

• Coordinate and monitor daily workflow in the pharmacy
• Lead team huddles and provide initial coaching and direction to pharmacy technicians
• Interact with healthcare providers and provide guidance to patients about medication coverage
• Support and train new employees
• Conduct quality and productivity audits
• Identify ongoing training and retraining opportunities on the team
• Create, modify, and adhere to SOP/SWI
• Cross-train in multiple areas while maintaining proficiency and accuracy
• Champion continuous improvement efforts for the team, site, and work stream
• Manage multiple tasks without sacrificing attention to detail

Pharmacy Technician Lead Representative

Customer Support

• Answer inbound phone calls in a high-volume contact center
• Support patients with medication orders, benefits explanations, billing inquiries, and complex issue resolution
• Follow structured workflows and maintain continuous call-taking until designated breaks
• De-escalate concerns and provide empathetic solutions within standard operating procedures
• Maintain patient confidentiality and comply with healthcare regulations
• Meet monthly performance metrics
• Participate in ongoing training and feedback
• Attend an 8-week virtual training program with live call-taking and assessments
• Work back-to-back calls in a highly structured environment
• Represent Accredo Specialty Pharmacy professionally while supporting patients with complex and critical health conditions

Customer Service Associate

Nurse

• Provide safe and effective administration of specialty medications, including IV infusion, in patients' homes
• Partner with pharmacists and care teams to ensure holistic patient well-being
• Document assessments, treatments, and progress to maintain accurate patient records
• Serve as the primary point of contact for patient updates and care coordination
• Demonstrate autonomy in clinical decision-making to achieve optimal outcomes

Specialty Infusion Field Nurse

• Coordinate and monitor daily workflow in the pharmacy
• Lead team huddles and provide initial coaching and direction to pharmacy technicians
• Interact with healthcare providers and provide guidance to patients about medication coverage
• Support and train new employees
• Conduct quality and productivity audits
• Identify ongoing training and retraining opportunities on the team
• Create, modify, and adhere to SOP/SWI
• Cross-train in multiple areas while maintaining proficiency and accuracy
• Champion continuous improvement efforts for the team, site, and work stream
• Juggle multiple tasks without sacrificing attention to detail

Lead Pharmacy Technician

Supervisor

• Provide daily leadership, coaching, and support to Benefit Investigation and Prior Authorization Representatives
• Monitor team productivity, quality, service levels, and turnaround times
• Conduct one-on-one meetings, performance evaluations, and career development discussions
• Manage staffing, scheduling, workload distribution, and workflow prioritization
• Oversee pharmacy benefit investigations, coverage reviews, and prior authorization activities
• Partner with providers, health plans, pharmacies, and internal business partners to resolve complex issues
• Ensure accurate documentation and compliance with payer requirements, HIPAA regulations, and company policies
• Identify and implement process improvements
• Analyze operational metrics and prepare performance reports for leadership
• Support onboarding, training, cross-training, and ongoing development
• Lead team meetings, huddles, and communication initiatives
• Serve as subject matter expert and escalation point for complex cases
• Collaborate with leadership on departmental goals, strategic initiatives, and business priorities
• Promote accountability, collaboration, quality, and continuous improvement

Supervisor, Benefit Investigation & Prior Authorization Team

• Interpret physicians’ and prescribers’ prescriptions
• Contact physicians, prescribers, and patients to verify prescription information and expedite order processing
• Consult with patients regarding medication use and potential drug interactions
• Track order status and outstanding issues
• Handle customer calls regarding lost orders or dispensing errors
• Maintain daily production, quality, and service levels
• Vary work priorities and activities to accommodate business needs
• Provide oversight and quality assurance to pharmacy technicians
• Verify and confirm validity of controlled substances
• Verify prescription information entered by data entry or order entry
• Collaborate with physicians to convert prescriptions to generic or preferred drugs when possible
• Back up other pharmacists as needed
• Train less experienced pharmacists
• Perform additional duties assigned by management

Health Coach

• Conduct individual health coaching sessions
• Identify members’ health advocacy needs
• Use motivational interviewing and engagement strategies to support employee health and wellness
• Provide onsite support to help members identify behavior changes that improve health status, reduce health risks, and improve quality of life
• Deliver health and wellness education through group presentations, support groups, games, quizzes, newsletters, and other media
• Follow up with employees regarding wellness program engagement and future education or referral needs
• Educate employees about wellness programs, tools, and services
• Raise awareness and visibility for wellness initiatives
• Schedule and coordinate wellness events, campaigns, and appointments
• Prepare patients for virtual provider visits
• Perform CLIA-waived testing, laboratory work, input HPI information, biometric testing, and vaccine administration
• Manage the day-to-day operations of the health centers
• Cover health centers in Peachtree City and Griffin, Georgia

RN Health Coach

• Answer inbound phone calls in a high-volume contact center
• Support patients with medication orders, benefits explanations, billing inquiries, and complex issue resolution
• Follow structured workflows and continuous call-taking schedules
• De-escalate concerns and provide empathetic solutions within standard operating procedures
• Maintain patient confidentiality and comply with healthcare regulations
• Meet monthly performance metrics
• Participate in ongoing training and feedback
• Attend and participate in the paid 8-week virtual training program, including live call-taking and assessments
• Handle sensitive health-related issues accurately and responsibly
• Work at a computer and remain seated for extended periods throughout each shift

• Actively manage pharmacy claim billing, collections, and follow-up activities
• Resolve denied, rejected, or underpaid claims by identifying root causes and applying corrective strategies
• Interpret explanations of benefits (EOBs) to validate reimbursement accuracy and determine next steps
• Monitor accounts receivable and manage outstanding balances through payer or patient outreach
• Prepare, submit, and track payer appeals within required timeframes
• Evaluate payer rules and reimbursement guidelines to determine whether claims should be corrected, refiled, or appealed
• Identify and correct billing or submission errors affecting reimbursement
• Maintain timely documentation of collection activity in patient notes and reporting tools
• Partner with teammates and leaders to identify workflow improvements that strengthen efficiency, compliance, and financial performance
• Support CarepathRx within Evernorth Health Services’ Pharmacy and Care Delivery organization in delivering specialty pharmacy and infusion services

Specialty Infusion Field Nurse, Per Diem

Account Executive

• Leverage pharmacy and healthcare expertise to meet Health Plan clients’ strategic goals and improve clinical and financial outcomes
• Develop and present comprehensive healthcare strategies aligned with client strategic goals
• Manage a book of moderately complex clients
• Analyze healthcare data and draw actionable insights
• Partner with Pharmacy Directors, Medical Directors, and clinical staff on comprehensive management plans
• Lead adoption of clinical solutions through consultative sales methods, client P&T presentations, and business reviews
• Lead custom formulary management recommendation discussions
• Partner with Account Executives and Finance/Formulary teams to manage rebate performance
• Lead development, preparation, and presentation of healthcare strategies
• Lead clinical client Strategic Planning and Review Consultation meetings
• Support client retention, loyalty, satisfaction, and solution sales opportunities
• Share best practices and interpret drug trends affecting health plan benefits
• Participate in process improvement initiatives
• Build trusted client relationships and communicate client feedback to internal partners
• Serve as the primary clinical resource and new-solution product expert

Client Service Executive

Senior Enrollment/Billing Representative, Home Infusion

Staff Pharmacist

Pharmacy Technician Lead Representative

Customer Service Associate

Specialty Infusion Field Nurse

Lead Pharmacy Technician

Supervisor, Benefit Investigation & Prior Authorization Team

Specialty Infusion Field Nurse

Staff Pharmacist

RN Health Coach

Customer Service Associate

Senior Enrollment/Billing Representative, Home Infusion

Specialty Infusion Field Nurse, Per Diem

Clinical Account Executive – Health Plans