Human Resources Specialist

The Customer Service Associate Representative provides support to participants, clients, and providers by answering inquiries related to group health benefits and claims payments. The role also includes researching claims, documenting interactions, and assisting team members as needed.<br><br><strong>Essential Job Functions<br><br></strong><ul><li>Answer telephone calls from plan participants, group contacts, and providers regarding benefits and claims.</li><li>Provide clear, accurate, and timely responses to information requests.</li><li>Document all calls in Chronolog by summarizing key points of each conversation.</li><li>Return messages from designated voicemail boxes.</li><li>Read, interpret, and apply plan documents, new amendments, and updates for multiple clients.</li><li>Meet with clients as needed to assist with questions about their health benefit plans.</li><li>Support team members and cross‑functional partners as requested.</li><li>Log faxed claims and enter fax information into Chronolog.</li><li>Return misdirected claims to the appropriate provider.</li><li>Assist members with navigating the website.</li><li>Meet or exceed company standards for quality and production.</li><li>Maintain punctual and reliable attendance.</li><li>Support claim information research and identification.</li><li>Assist with provider record maintenance tasks.</li><li>Index claims and correspondence batches.</li><li>Complete responsibilities assigned for specific client groups.</li><li>Aid in employee training and cross‑training.</li><li>Research and prepare refund documentation.<br><br></li></ul>Quality Assurance Measurements<br><br><ul><li>Consistently meet or exceed company standards for production, quality, and audit performance.<br><br></li></ul>Minimum Education<br><br><ul><li>High school diploma or GED required.<br><br></li></ul><strong>Minimum Experience<br><br></strong><ul><li>Basic computer and customer service experience.</li><li>Excellent verbal and written communication skills.</li><li>Proficiency with PC tools including Windows, Word, and Adobe Acrobat; ability to learn new software.</li><li>Minimum typing speed of 45 wpm.</li><li>Strong listening skills and attention to detail.</li><li>Basic mathematical competency.</li><li>High interpersonal skills and the ability to work collaboratively.</li><li>Ability to organize and recall large amounts of detailed information.</li><li>Capability to read, analyze, and interpret benefit plans, insurance documents, and regulations.</li><li>Professional attitude with the ability to project a positive image in all work environments.</li><li>Commitment to privacy and confidentiality standards.</li><li>Flexibility to work under pressure and meet deadlines.</li><li>Strong problem‑solving abilities with professionalism and patience.<br><br></li></ul><strong>About Allegiance By Cigna Healthcare<br><br></strong>Since 1981, Allegiance by Cigna Healthcare has specialized in administering medical benefits, including claims processing, customer service, utilization management, and case management. With a high‑touch approach to member and client service, Allegiance supports some of the nation’s most innovative health benefit strategies.<br><br>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.<br><br>For this position, we anticipate offering an hourly rate of 17.75 - 19 USD / hourly, depending on relevant factors, including experience and geographic location.<br><br>This role is also anticipated to be eligible to participate in an annual bonus plan.<br><br>At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), 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, click here.<br><br><strong>About Cigna Healthcare<br><br></strong>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.<br><br><em>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.<br><br></em><em>If you need a reasonable accommodation to complete the online application process, please email </em><em><strong>seeyourself@thecignagroup.com</strong></em><em> for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.<br><br></em><em>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.<br><br></em><em>Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.</em><br/><br/>Please mention the word **CHIC** and tag RMTUyLjU1LjE4NC44NA== when applying to show you read the job post completely (#RMTUyLjU1LjE4NC44NA==). This is a beta feature to avoid spam applicants. Companies can search these words to find applicants that read this and see they're human.