Jason Sauer
Cigna HealthCare
Nanticoke,PA
13
years of professional experience
Served as customer service representative by listening actively, assessing customer needs, and solving problems to address inquiries.
Work History
Quality Review and Audit Analyst.
4 Years 1 Month- Reviewed renewal letters, invoices, and vendor correspondence for errors.
- Listened to dental and medical sales calls, reviewed call quality, and provided feedback to vendor on possible errors.
- Assisted with review and feedback for new dental sales vendor added to vendor list.
Benefit Coverage Clarification Team
3 Years 2 Months- Processed benefit coverage clarifications and supported claim adjustments tied to each case.
- Assisted with newborn Medicare primacy, dependent maternity, bariatric, and Amplifon hearing aid coverage questions received through escalated email.
- Supported appeals involving benefit coverage clarifications.
Care Advocate for Individual and Family plan
1 Year 8 Months- Completed audit reviews for account accumulators.
- Processed medical CSA misquotes.
- Assisted with research and answered medical or pharmacy questions for individual and family plans.
- Supported complaints from department of insurance, social media, Cigna provider representatives, and executive office cases for individual and family plans.
- Served as point of contact for conversion members and handled account questions plus new clean claims routing to dedicated processors.
- Reviewed provider contracting concerns and sent contracting updates to provider maintenance team.
Customer Service Analyst
9 Months- Assisted with manager callbacks.
- Supported repeat caller project by listening to calls and providing coaching feedback in weekly reports.
- Helped supervisors with research inquiries requiring additional review.
- Placed outbound calls to customers to help locate valid PCP after invalid PCP selection.
- Served as subject matter expert for GSP site in Bogota, Colombia.
- Partnered with supervisors on escalated issues.
Customer Service Advocate/ Customer Service Sr. Advocate
3 Years 6 Months- Provided chat support for team questions.
- Answered questions sent to individual family plan team leads email box.
- Trained peers on follow-up management system.
- Supported new hire class as floor support.
- Participated in PAL program, assisting new peers with call handling.
- Assisted with provider issues, routing needed corrections to appropriate areas.
- Supported individual family plan transition of care project by making outbound calls to customers and updating accounts for transition of care status.
- Met and exceeded metrics.
- Worked well in team and individual settings.
- Answered member inquiries by phone regarding employer-sponsored plans and self-purchased medical plans.
- Submitted potential claim processing errors to claims processor for adjustment.
Education
High School Diploma
Skills
Coordinated workflow priorities across tasks and deadlines to keep work moving.
Provided team support through effective problem resolution and practical troubleshooting.
Maintained clear communication with coworkers and customers to support smooth coordination.
Applied Excel and Microsoft Word for tracking
formatting
and document preparation.
Timeline
Quality Review and Audit Analyst.
Cigna HealthCare
10.2022 - 11.2026Read More
Benefit Coverage Clarification Team
Cigna HealthCare
08.2019 - 10.2022Read More
Care Advocate for Individual and Family plan
Cigna HealthCare
12.2017 - 08.2019Read More
Customer Service Analyst
Cigna HealthCare
03.2017 - 12.2017Read More
Customer Service Advocate/ Customer Service Sr. Advocate
Cigna HealthCare
09.2013 - 03.2017Read More
Greater Nanticoke Area School District
High School Diploma
Read More