As a Client Account Support Advisor on the Centene Operations Adjustments team, you will work directly with client contacts and finance analysts to correct claims that processed incorrectly due to benefit setup issues, resulting in system-generated member and/or client refunds. You will also be responsible for reporting to analyze client credit requests and ensure that the ESI liability is accurate. Role requires strong client account and PBM operational knowledge. Position is accountable for assigned work with a focus on client satisfaction, quality, timeliness, performance guarantees and the effective use of cross-functional partnerships. Position requires strong analytical skills to drive resolution of complex adjustments and client credits. Role is empowered to identify and drive solutions and improvements for client and ESI processes. Role will take on any special projects as assigned. Role requires navigation across numerous operational areas within our organization.
Education: High School Diploma required; Bachelor's degree preferred.
Experience: + 2+ years of professional experience required. + Experience in healthcare or PBM industry preferred. + Client-facing experience preferred. + Previous quality and process improvement experience strongly advised. + Prior knowledge of project management or program management execution preferred. + Demonstrated ability managing projects using proven project management processes.
Skills: + Excellent verbal and written communication and presentation skills. + Strong focus on quality, effective communication, critical thinking, problem-solving, and customer service. + Strong analytical skills and ability to collaborate with various stakeholders. + Proven experience with Microsoft Word, Excel, Outlook, and PowerPoint. + Excellent organizational skills with the ability to multi-task and manage multiple priorities. + Advanced problem-solving skills and ability to work cross-functionally. + Ability to adapt to a dynamic work environment and make decisions with minimal oversight. + Ability to clearly communicate status, issues, risks, and challenges.
Attributes: + Strong initiative, commitment, and ability to work under pressure and meet tight deadlines. + Flexibility to support peak seasons and a flexible schedule. + Ability to build and maintain strong cross-functional networks. + Ability to operate in a fast-paced, dynamic organization. + Ability to work within a complex, matrix environment. + Ability to create a team dynamic to maximize a team environment. + Willingness to travel overnight. 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.
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. That's why 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) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays.
Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives.