PAC Case Administrator - Work from Home - eviCore

Cigna

Houston, TX, USA

Full time

Healthcare / Insurance

Mar 17

This job is no longer accepting applications.

The Post-Acute Care (PAC) Case Administrator responsibilities include but not limited to:

  • Maintain workflow activities for the PAC Health plan product for inbound and outbound communications between eviCore Healthcare stakeholders and external hospitals, physicians and Post-Acute Care providers.
  • Demonstrate complete understanding of how to research and resolve issues pertaining to the pre-certification process and day-to-day operational concerns using defined processes while communicating all state specific and national health care laws to external hospitals, physicians and Post-Acute Care providers including the appeals/reconsideration policies.
  • Demonstrate full understanding and ability to differentiate the Post-Acute Care processes over multiple health plans across multiple states to ensure compliance with both Medicare and Medicaid guidelines by state regulations.
  • Status checks on existing cases, directing calls to internal departments, notification calls to hospitals and Post-Acute Care providers regarding incomplete pre-certification requests, as well as authorization approvals.
  • Receive faxed information via internal and external systems from hospitals, physicians and Post-Acute Care providers, completing the activity for the request including case creation for pre-certification, attaching to an existing case for re-certification, and assigning to the appropriate staff for case closure. 

Education:

  • High School graduate with diploma or GED. 

Experience:

  • Various schedules to cover operating hours (7AM – 8PM CST).
  • Daily focus on attaining productivity standards, recommending new approaches for enhancing performance and productivity when appropriate.
  • Communication: Ability to provide clear verbal and written information via in-person, email, and phone to customers, co-workers, and leadership.
  • Critical-Thinking/Decision-making: Ability to choose a course of action or developing appropriate solutions by identifying and understanding issues, problems, and opportunities.

For this position, we anticipate offering an hourly rate of $16 - $22, depending on relevant factors, including experience and geographic location.This role is also anticipated to be eligible to participate in an annual bonus plan.

Helping our customers achieve healthier, more secure lives is at the heart of what we do. While you take care of our customers, we’ll take care of you through a comprehensive benefits program that helps you be at your best. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and best in class well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and dozens of corporate discounts on essentials you use every day. For more details on our employee benefits programs, please visit the “Life at Cigna” tab on our careersite: www.cigna.com/careers

About Cigna

Cigna Corporation exists to improve lives. We are a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. Together, with colleagues around the world, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation. When you work with us, or one of our subsidiaries, you’ll enjoy meaningful career experiences that enrich people’s lives. What difference will you make?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.

If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.

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