Provider Relations & Claims Advocate

The Cigna Group

Claims and provider relations advocate handling inbound behavioral health calls for Evernorth Health Services. Resolving claims, authorizations, contracts, complaints, and payment issues.

Posted 8/5/2026full-timeRemote • 🇺🇸 United StatesMid-LevelSenior💰 $24 - $37 per hourWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates strong customer service skills with a focus on handling claims and provider relations in a virtual team environment. Proficient in using multiple applications for issue resolution and effective communication with members and providers.

Highest-signal resume keywords

Bachelor's DegreeCustomer Service ExperienceBehavioral Health Claims HandlingTechnical Aptitude with Multiple SystemsEffective Communication Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims ProcessingIssue ResolutionTyping SkillsProblem-SolvingTime Management

Soft Skills

Interpersonal SkillsOrganizational AbilitiesEffective Listening

Tools & Technologies

Multiple ApplicationsPC Skills

Industry Keywords

Provider RelationsEOB ProcessingAdvocate HandoffBehavioral Health

About the role

Key responsibilities & impact

Answer inbound calls from members and providers regarding claims, contracting, and provider relations
Handle a high volume of calls in a structured phone queue environment
Make outbound calls for issue resolution and follow-up
Use multiple applications during calls to research and resolve inquiries
Address claim status inquiries and explanations
Process requests for claim reprocessing or adjustments
Handle provider contract questions and demographic updates
Correct authorizations to ensure proper claim payment
Process requests for duplicate EOBs or check reissuance
Handle escalated issues through Advocate Handoff/Help Request (AHHR)
Submit complaints on behalf of members or providers
Email resources and documentation to callers

Requirements

What you’ll need

Bachelor’s degree is required
Proven customer service experience
Prior Evernorth Behavioral Care Specialist/Advocacy experience preferred
Experience handling behavioral health claims and provider relations calls is a plus
Ability to thrive in a virtual team environment
Strong interpersonal and communication skills
Effective listening and organizational abilities
Technical aptitude with multiple systems and applications
Independent problem-solving and time management skills
Proficient typing and PC skills
Availability for Monday–Friday shifts between 7:00 AM and 7:00 PM CT after training
Training availability Monday–Friday, 8:30 AM–5:00 PM CT
Cable broadband or fiber optic internet service with at least 10 Mbps download and 5 Mbps upload for home work

Benefits

Comp & perks

Annual bonus plan eligibility
Medical benefits
Vision benefits
Dental benefits
Well-being and behavioral health programs
401(k)
Company-paid life insurance
Tuition reimbursement
Minimum of 18 days of paid time off per year
Paid holidays
Leaves of absence
Work-from-home arrangement