Clinical Customer Advocate
Clinical Customer Advocate
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Job Description
We are seeking a compassionate and skilled Nurse to join our team on a parttime basis. In this role you will leverage your clinical expertise to communicate coverage decisions including denials to individual health insurance members. This position requires a blend of clinical knowledge strong communication skills and emotional intelligence to ensure our members are treated with empathy clarity and respect during challenging conversations.
Key Responsibilities:
Review and understand clinical documentation and insurance policies to effectively communicate coverage decisions.
Deliver denial notifications to members ensuring explanations are clear accurate and empathetic.
Address member questions and concerns regarding coverage decisions in a professional and compassionate manner.
Collaborate with internal teams including medical directors and case managers to ensure accurate and informed communication.
Document member interactions in compliance with company policies and regulatory standards.
Support the appeals process by providing clear guidance and necessary documentation when applicable.
- Additional responsibilities: Support other team members at different stages of customer support (pre or post service ongoing procedures) by reviewing clinical information and communicating decisions.
Qualifications:
Registered Nurse (RN) or equivalent nursing qualification with a valid license in applicable region.
Minimum of 3 years clinical experience preferably in insurance case management or patient advocacy.
Strong verbal and written communication skills with the ability to explain complex medical and insurance terms clearly.
Demonstrated empathy patience and resilience in dealing with sensitive situations.
Ability to work independently while maintaining a high standard of professionalism.
Proficiency with electronic medical records (EMR) systems and basic computer skills.
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: for support. Do not email for an update on your application or to provide your resume as you will not receive a response.
Employment Type
Part-Time
