Evernorth (Cigna Health Solutions India Private Limited) is seeking an Intake Care Associate Analyst to join our Clinical Operations team. In this role, you will be responsible for the timely intake and processing of incoming cases and Guarantee of Payments, acting as a crucial link between medical providers and insured individuals.
What You'll Do
- Perform timely intake and processing of all incoming cases as well as Guarantee of Payments.
- Analyze requests for hospitalization, evaluating treatments, amount, and length of stay according to policy.
- Act as a liaison between medical providers and the insured individual, primarily by phone, to obtain all necessary information.
- Review and monitor cases to ensure files are cascaded to appropriate teams based on specific triggers.
- Serve as the point of contact for hospitals regarding all questions related to the Guarantee of Payment.
- Negotiate discounts with providers.
- Maintain all necessary hospitalization information in an internal database.
- Translate and interpret medical and other relevant documents for case analysis.
- Work independently and communicate effectively with internal and external customers via telephone and email.
- Maintain accurate workflow and process documentation following outlined procedures.
What We're Looking For
- High School Diploma.
- 1-2 years of experience in a customer service or claims environment.
- Ability to speak, write, and read English.
- Business Application skill: ability to initiate research, plan, and coordinate.
- Proven ability to build relationships with matrix partners.
- Ability to work and problem-solve independently, escalating when necessary.
- Skill in conveying information clearly to medical providers, internal partners, and customers.
- A background in Medical Terminology.
Nice to Have
- Experience in a healthcare operations background.
- Ability to speak, write, and read any other language is a plus.
Team & Environment
You will be a member of the Clinical Operations team, working closely with the Pre-Authorization team.
Work Mode
This position operates on a global work mode.
Evernorth is an equal opportunity employer.