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Prior Authorization Representative
The Cigna Group. Respond primarily to phone inquiries from members, providers, and/or pharmacies .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates strong customer service skills and effective communication while navigating multiple applications and adhering to HIPAA regulations. Proven ability to maintain accurate documentation and collaborate with team members to resolve inquiries efficiently.
Highest-signal resume keywords
Call Center Customer Service ExperienceExcellent Communication SkillsOrganizational SkillsMicrosoft Outlook ProficiencyHIPAA Compliance Knowledge
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Medication Prior AuthorizationInquiry DocumentationIssue ResolutionWindows ProficiencyMultiple Application Navigation
Soft Skills
EmpathyCalmness Under PressureFlexibilityCollaboration
Tools & Technologies
Microsoft OutlookWindows Operating System
Certifications & Qualifications
High School DiplomaGED
Industry Keywords
Healthcare BackgroundStandard Operating ProceduresCustomer Service MetricsDoD SCA County
About the role
Key responsibilities & impact- Respond primarily to phone inquiries from members, providers, and/or pharmacies
- Respond to fax inquiries as needed
- Facilitate medication prior authorization requests
- Review system documentation and provide straightforward, empathetic information
- Use multiple applications to obtain information
- Follow standard operating procedures, corporate documentation, and HIPAA regulations
- Research and resolve issues proactively, seeking assistance when needed
- Maintain accurate and complete inquiry documentation
- Collaborate with others to apply best practices
- Meet or exceed call center and other business metrics
- Provide excellent and consistent customer service
- Attend assigned training classes
- Work on assigned tasks and projects
Requirements
What you’ll need- High School Diploma / GED
- 1+ years call center customer service experience
- Excellent customer service and communication skills
- Strong organizational skills
- Intermediate proficiency in Microsoft Outlook
- Working knowledge of Windows
- Ability to navigate multiple screens and applications
- Ability to remain calm and helpful in difficult situations
- Flexibility to support extended hours and overtime based on business needs
- 100% attendance throughout training/on-the-job training and excellent attendance thereafter
- Must live in a DoD SCA County
- Must work any schedule between operating hours ranging from 7:00am–10:00pm Eastern time, Monday through Friday
- Reliable high-speed broadband internet with a hard-wired connection of at least 10 Mbps download/5 Mbps upload
- Quiet and private work space without interruption
- Healthcare background preferred
Benefits
Comp & perks- Annual bonus plan eligibility
- Medical, vision, and dental benefits starting on day one
- Well-being and behavioral health programs
- 401(k)
- Company-paid life insurance
- Tuition reimbursement
- Minimum of 18 days of paid time off per year
- Paid holidays
- Leaves of absence
- Work-from-home arrangement
- Hard-wired high-speed broadband internet requirement for home working