Eligibility Analyst, Specialty

🔥 3 minutes ago

🇺🇸 United States – Remote

💵 $22 - $34 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🧐 Analyst

🚫👨‍🎓 No degree required

👻 Ghost score 0%

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The Cigna Group

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

🛡️ Insurance

Healthcare • Insurance

The Cigna Group is a global health services company that provides medical, dental, pharmacy, behavioral and supplemental insurance products and benefits to individuals, families, employers, brokers, providers and Medicare beneficiaries. It offers employer-sponsored group plans, individual and family plans (including Open Enrollment offerings), Medicare, international health insurance covering more than 200 countries, and digital member services through the myCigna platform (including telehealth and claims management). Its products are delivered through operating subsidiaries such as Cigna Health and Life Insurance Company and other regional affiliates.

📋 Description

• Serve as the primary liaison between Intake and Revenue Cycle Management teams to resolve escalated insurance verification, eligibility, and authorization concerns • Analyze escalated cases to identify root causes, recurring trends, and process gaps affecting reimbursement, patient access, or operational quality • Recommend and support process improvements to reduce errors, strengthen accuracy, and improve team efficiency • Partner with supervisors and leaders to implement solutions, monitor results, and share progress toward sustainable improvements • Provide expert guidance on payer requirements, insurance verification, authorization processes, contract pricing, and test claims • Collaborate with intake staff to ensure insurance documentation is complete, accurate, and aligned with reimbursement needs • Maintain reference materials, workflows, and team resources supporting consistent decision-making • Coordinate case reviews and cross-functional discussions to align teams on action plans and account resolution • Generate reports summarizing issues, resolutions, trends, and recommendations for leadership • Support audits, quality reviews, team education, single patient agreements, price quotes, and other revenue cycle initiatives as needed

🎯 Requirements

• High school diploma or GED • Minimum of 2 years of experience in pharmacy claims, pharmacy technician work, healthcare revenue cycle operations, physician practice operations, ancillary healthcare services, or a related healthcare setting • Knowledge of medical terminology • Proficiency with Microsoft Office applications and other business systems • Strong written and verbal communication skills • Excellent customer service and relationship-building abilities • Strong problem-solving, organization, time management, and follow-through skills • Ability to work independently, manage priorities, and adapt in a fast-paced healthcare environment • Internet connection obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload when working from home • Ability to work Monday-Friday, 8:30am-5pm EST

🏖️ Benefits

• Annual bonus plan eligibility • Medical insurance • Vision insurance • Dental insurance • 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 • Remote work arrangement