- Répondre aux appels provenant de différents professionnels de la santé.
- Répondre aux questions sur l'admissibilité aux couvertures (soins dentaires, médicaments, équipement médical et fournitures médicales, soins médicaux complémentaires, soins de la vue et counseling en santé mentale) ainsi qu'à des questions relatives aux demandes de règlement.
- Déterminer les besoins de l'appelant et les évaluer.
- Répondre aux questions de manière exacte et donner des renseignements complets de façon rapide et professionnelle.
- Offrir du soutien technique, au besoin, afin d'aider les fournisseurs à soumettre leurs demandes de règlement par voie électronique.
- Collaborer avec les autres équipes et services de l'entreprise.
- Communiquer de manière efficace.
- Offrir une expérience client hors pair lors de chaque interaction.
- Accomplir d'autres tâches, au besoin.
- Présenter d'excellentes habiletés de communication à l'oral comme à l'écrit.
- Présenter d'excellentes habiletés interpersonnelles et être en mesure de travailler seul ou en équipe.
- Être en mesure de résoudre des problèmes.
- Être en mesure de travailler le jour, le soir et les jours fériés.
- Maîtriser la suite Microsoft Office (Word, Excel, Outlook) et avoir de bonnes aptitudes en saisie au clavier.
- Être bilingue, en français et en anglais.
- Respond to inbound calls from a variety of Health Care Providers
- Respond to inquiries regarding eligibility of health care benefits (Dental, Pharmacy, Medical Supplies and Equipment, Extended Health, Vision Care and Mental Health Counselling) and claim inquiries
- Identify and assess the caller's needs
- Provide accurate, and complete information in a prompt and professional manner
- Provide technical support where required to assist providers with electronic claims submissions
- Collaborate with other internal teams & departments
- Communicate effectively and efficiently
- Provide a world-class customer service experience with every interaction
- Other duties as assigned
- Excellent verbal and written communication skills
- Strong interpersonal skills with the ability to work independently and within a team environment
- Problem-solving skills
- Flexibility in working days, evenings and holidays
- Skilled in MS Office (Word, Excel, Outlook), along with strong keyboarding skills
- Bilingualism, English and French, is required
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Bilingual customer service representative - Toronto, Canada - The Cigna Group
Description
Le personnel du Centre d'appels à l'intention des fournisseurs agit à titre d'intermédiaire entre les fournisseurs et Express Scripts Canada en ce qui concerne les demandes quotidiennes relatives au traitement des demandes de règlement. Le représentant du Centre d'appels doit refléter l'engagement d'Express Scripts Canada en matière d'accessibilité et de rapidité de réponse aux fournisseurs. Ce poste est essentiel au maintien des niveaux de service et des objectifs contractuels.
Responsabilités principales
Les horaires associés à ce poste sont variables et peuvent comprendre les fins de semaine. Le Centre d'appels est ouvert du lundi au vendredi de 6 h 30 à minuit, ainsi que les fins de semaine et les jours fériés, de 8 h à minuit.
Compétences recherchées
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The Provider Call Centre is the main venue for communication between providers and Express Script Canada regarding day-to-day claims adjudication queries. The Customer Service Representatives reflect Express Script Canada's commitment to accessibility and responsiveness to providers. This position is instrumental in meeting contractual objectives and service levels.
Key Responsibilities:
Qualifications:
Express Scripts Canada is a Cigna company
Express Scripts Canada is a subsidiary of Express Scripts, a Cigna company. Cigna Corporation (NYSE: CI) is a global health service company dedicated to improving the health, wellbeing and peace of mind of those we serve. Cigna offers an integrated suite of health services through Cigna, Express Scripts, and our affiliates including medical, dental, behavioural health, pharmacy, vision, supplemental benefits, and other related products.
About Express Scripts Canada
Express Scripts Canada is a leading health benefits manager and has been recognized as one of the most innovative. Our clients include Canada's leading insurers, third party administrators and governments. We work with these clients to develop industry-leading solutions to deliver superior healthcare in a cost-controlled environment. We provide Active PharmacyTM services to more than 7 million Canadian patients and adjudicate more than 100 million pharmacy, dental, and extended health claims annually. Through our proprietary consumer intelligence, clinical expertise, and patients-first approach, we promote better health decisions for plan members, while managing and reducing drug benefit costs for plan sponsors.
It will be a condition of employment that the successful candidate obtains an Enhanced Reliability Clearance from the Federal Government. The candidate will be required to provide supporting documentation to receive clearance if required.
We offer a competitive salary and benefits package, along with a positive work environment built on solid corporate values, integrity, mutual respect, collaboration, passion, service and alignment.
We are an equal opportunity employer that promotes a diverse, inclusive and accessible workplace. By embracing diversity, we build a more effective organization that empowers our employees to be the best that they can be.
We are committed to creating a working environment that is barrier-free and we are prepared to provide accommodation for people with disabilities.
