Grievance Customer Service Associate Analyst (Team Lead) – Cigna Healthcare – Remote in USA ID - 1439

December 14, 2024

The Grievance team manages Cigna Healthcare – Medicare/Medicaid grievances that are presented by our memberâ€™s or their representatives pertaining to the authorization of or delivery of clinical and non-clinical services. Grievance works in collaboration with divisions within and outside the organization to resolve issues in a timely and compliant manner.

The Grievance Team Leader is the subject matter expert responsible for overseeing the execution and performance of the Grievance team. The Team Lead will provide guidance, instruction, direction and leadership to the grievance team, for the purpose of achieving key results.

The Team Lead monitors the quantitative and qualitative achievements of the team and reports results to a management team. The Team Lead will enable Grievance Coordinator to bring cases to resolution within CMS guidelines.

Responsibilities:

Manages a team of Grievance Coordinators with responsibility for goal and productivity management, coaching and counseling, provide feedback to management team and other leadership responsibilities as assigned.
Delivers training to employees as needed and ensures new hires have proper work tools and are trained accordingly.
Ensures Grievance Coordinators expedite timely requests for information and that cases meet compliance.
Understands Cignaâ€™s internal health plans policies and procedures to frame decisions.
Makes critical decisions in support of the business as needed.
Manage all duties within CMS regulatory timeframes and Interpret CMS regulations and policies as needed.
Communicate effectively to hand-off and pick-up work from colleagues.
Responsible for ensuring that the team meets/exceeds production and quality goals.

Other Jobs You May Be Interested In

Qualifications:

Apply Job!

Bachelor’s or associate degree in related field; in lieu of a degree, a high school diploma
2 or more years in a Medicare, Medicaid managed care environment investigating and resolving Grievances required.
Experience in clinical practice with experience in appeals & grievances, claims processing, utilization review or utilization management/case management.
Strong written and verbal communication skills, ability to work independently on several computer applications such as Microsoft Word and Excel, as well as corporate email
Demonstrated ability to manage large caseloads and effectively work in a fast-paced environment.

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

For this position, we anticipate offering an hourly rate of 17 – 26 USD / hourly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

We want you to be healthy, balanced, and feel secure. Thatâ€™s why youâ€™ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, youâ€™ll be offered several health-related benefits including medical, vision, dental, and 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 paid holidays. For more details on our employee benefits programs, visit .

About Cigna Healthcare

Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.

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.

The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.

Expected salary:

Location: USA

Back to blog

Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

This is what this question poses: When do you focus and start working seriously? What are the hours you work optimally? Are you a night owl? A morning bird? Remote teams can be made up of people working on different shifts and around the world, so you won't necessarily be stuck in the 9-5 schedule if it's not for you...

2. HOW DO YOU USE THE DIFFERENT COMMUNICATION TOOLS IN DIFFERENT SITUATIONS?

When you're working on a remote team, there's no way to chat in the hallway between meetings or catch up on the latest project during an office carpool. Therefore, virtual communication will be absolutely essential to get your work done...

3. WHAT IS "WORKING REMOTE" REALLY FOR YOU?

Many people want to work remotely because of the flexibility it allows. You can work anywhere and at any time of the day...

4. WHAT DO YOU NEED IN YOUR PHYSICAL WORKSPACE TO SUCCEED IN YOUR WORK?

With this question, companies are looking to see what equipment they may need to provide you with and to verify how aware you are of what remote working could mean for you physically and logistically...

5. HOW DO YOU PROCESS INFORMATION?

Several years ago, I was working in a team to plan a big event. My supervisor made us all work as a team before the big day. One of our activities has been to find out how each of us processes information...

6. HOW DO YOU MANAGE THE CALENDAR AND THE PROGRAM? WHICH APPLICATIONS / SYSTEM DO YOU USE?

Or you may receive even more specific questions, such as: What's on your calendar? Do you plan blocks of time to do certain types of work? Do you have an open calendar that everyone can see?...

7. HOW DO YOU ORGANIZE FILES, LINKS, AND TABS ON YOUR COMPUTER?

Just like your schedule, how you track files and other information is very important. After all, everything is digital!...

8. HOW TO PRIORITIZE WORK?

The day I watched Marie Forleo's film separating the important from the urgent, my life changed. Not all remote jobs start fast, but most of them are...

9. HOW DO YOU PREPARE FOR A MEETING AND PREPARE A MEETING? WHAT DO YOU SEE HAPPENING DURING THE MEETING?

Just as communication is essential when working remotely, so is organization. Because you won't have those opportunities in the elevator or a casual conversation in the lunchroom, you should take advantage of the little time you have in a video or phone conference...

10. HOW DO YOU USE TECHNOLOGY ON A DAILY BASIS, IN YOUR WORK AND FOR YOUR PLEASURE?

This is a great question because it shows your comfort level with technology, which is very important for a remote worker because you will be working with technology over time...

DISCLAIMER

Other Jobs You May Be Interested In

Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

2. HOW DO YOU USE THE DIFFERENT COMMUNICATION TOOLS IN DIFFERENT SITUATIONS?

3. WHAT IS "WORKING REMOTE" REALLY FOR YOU?

4. WHAT DO YOU NEED IN YOUR PHYSICAL WORKSPACE TO SUCCEED IN YOUR WORK?

5. HOW DO YOU PROCESS INFORMATION?

6. HOW DO YOU MANAGE THE CALENDAR AND THE PROGRAM? WHICH APPLICATIONS / SYSTEM DO YOU USE?

7. HOW DO YOU ORGANIZE FILES, LINKS, AND TABS ON YOUR COMPUTER?

8. HOW TO PRIORITIZE WORK?

9. HOW DO YOU PREPARE FOR A MEETING AND PREPARE A MEETING? WHAT DO YOU SEE HAPPENING DURING THE MEETING?

10. HOW DO YOU USE TECHNOLOGY ON A DAILY BASIS, IN YOUR WORK AND FOR YOUR PLEASURE?

Related Posts

Technical Support Engineer, Night Shift ID - 2077

Cafe Barista Weekend Shift Manager ID - 2074

Data Entry Clerk Remote Work From Home - Part-Time Focus Group Panelists ID - 2069

College Student - Content Creator ID - 2064

Content Moderator For Social Media - Work Remote - No Experience Needed ID - 2059

Call Center Mattress Sales ID - 2054

Part-Time Human Resources Assistant - Garden City - Friedman Vartolo LLP ID - 2048

Remote Part Rime Data Entry - No Experience ID - 2043