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Prior Authorization Representative
The Cigna Group. Review and respond to phone and/or fax inquiries from members and healthcare professionals .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates strong customer service skills and the ability to navigate multiple applications while adhering to HIPAA regulations. Maintains accurate documentation and collaborates effectively to resolve inquiries in a call center environment.
Highest-signal resume keywords
Call Center Customer Service ExperienceExcellent Communication SkillsOrganizational SkillsIntermediate Proficiency in Microsoft OutlookHealthcare Background
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 AuthorizationsInquiry DocumentationIssue ResolutionStandard Operating ProceduresHIPAA Compliance
Soft Skills
EmpathyFlexibilityCalmness Under Pressure
Tools & Technologies
Microsoft OutlookWindows Operating SystemMultiple Applications
Certifications & Qualifications
High School DiplomaGED
Industry Keywords
HealthcareCustomer ServiceCall CenterPrior AuthorizationDoD SCA County
About the role
Key responsibilities & impact- Review and respond to phone and/or fax inquiries from members and healthcare professionals
- Assist with medication prior authorizations
- Review system documentation and provide straightforward, empathetic information
- Respond primarily to inquiries from members, providers, and pharmacies
- Facilitate prior authorization requests
- Use multiple applications to obtain information
- Follow standard operating procedures, corporate documentation, and HIPAA regulations
- Research and resolve issues, seeking assistance as needed
- Maintain accurate and complete inquiry documentation
- Collaborate with others to apply best practices
- Meet or exceed call center and business metrics
- Provide excellent and consistent customer service
- Attend assigned training classes
- Complete 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
- Healthcare background preferred
- Ability to remain calm and helpful when dealing with 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 within operating hours ranging from 7:00am–10:00pm Eastern time, Monday through Friday
- Reliable high-speed broadband internet with a hard-wired connection, at least 10 Mbps download/5 Mbps upload
- Quiet and private work space without interruption
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
- Remote work/home-based arrangement