Client Service Center Analyst - Express Scripts - Remote

Client Service Center (CSC) Analyst

The Client Service Center (CSC) Analyst serves as an advocate for members by resolving escalated and complex pharmacy benefit issues that impact access to care, affordability, and understanding of benefits. The CSC Analyst partners closely with clients and members to research and resolve concerns accurately, efficiently, and with a high sense of urgency, while adhering to established performance and quality guidelines.

This role requires thorough documentation of inquiries and resolutions in a centralized database, as well as the ability to identify recurring issues or trends in order to support process improvements. The CSC Analyst may also support leadership with workload coordination and appropriately escalate issues to ensure timely and effective outcomes for members.

Essential Functions:

• Exercise independent judgment to research and resolve complex, sensitive, or critical member and client issues.
• Collaborate with cross-functional departments to investigate issues and determine appropriate resolutions.
• Review, process, and respond to internal and member requests in accordance with service level and performance agreements.
• Maintain accurate, complete, and timely documentation of all inquiries, actions taken, and resolutions.
• Research and process pharmacy benefit adjustment requests.
• Identify, document, and report recurring issues, trends, or questions, and recommend potential process or procedural improvements.
• Conduct outbound calls to members regarding adjustment requests, providing clear and timely communication on determinations, including when adjustments are approved or denied.
• Review recorded calls between members and Member Services to ensure information provided is clear, accurate, compliant, and consistent with benefit policies.
• Support additional projects, initiatives, and responsibilities as assigned by leadership.

Qualifications:

• High school diploma or equivalent required.
• Four (4) or more years of experience in a customer service environment preferred.
• One (1) or more years of experience supporting Medicare Part D preferred.
• Minimum of two (2) years of experience in an Express Scripts (ESI) contact center environment required.
• Resolution Team Lead experience preferred.
• Strong knowledge of ESI products and services required.
• Proficient working knowledge of CSP required.
• Excellent verbal and written communication skills, including professional phone presence.
• Demonstrated ability to handle challenging or escalated customer interactions in a professional and composed manner.
• Ability to adapt in a fast-paced, dynamic environment; learn quickly; solve problems; and make sound decisions with minimal supervision.
• General PC proficiency, including Microsoft Office, email, internet usage, and detailed knowledge of ESI call center systems.
• Ability to multitask effectively and manage competing priorities.
• Willingness to work a flexible schedule during peak call times as business needs require.
• Bilingual (Spanish) skills a plus

Shift: Monday – Friday, 9:00 AM – 6:00 PM EST

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.

For this position, we anticipate offering an hourly rate of 24 - 36 USD / hourly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

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.

About Evernorth Health Services

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.

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 need a reasonable accommodation to complete the online application process, please email seeyourself@thecignagroup.com for assistance.  Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.

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.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.