Eligibility Representative, Specialty

Job not on LinkedIn

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $17 - $26 / hour

⏰ Full Time

🟢 Junior

🚫👨‍🎓 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

• Verify patient insurance coverage, calculate estimated costs, and document details in patient profiles • Enter and update accurate patient demographics in the system • Generate coverage and financial responsibility quotes • Review benefits with patients by phone • Track, monitor, and secure required insurance and reimbursement documents • Obtain prior authorizations • Coordinate financial assistance forms, payment agreements, and waivers • Help train new employees during onboarding • Organize and prioritize daily tasks to meet productivity and quality standards • Create new hospital and physician codes as needed • Partner with internal teams to support reimbursement workflows and client service • Research reimbursement issues and contribute to continuous improvement efforts

🎯 Requirements

• High school diploma or GED • 1+ year of insurance verification, prior authorization, or related experience in a healthcare setting • Knowledge of medical terminology • Proficient computer skills, including Microsoft Office • Strong math, communication, and organizational skills • Experience with payer websites and coordination of benefits preferred • Knowledge of pharmacy versus medical payers and authorization processes preferred • Familiarity with plan formularies and authorization requirements preferred • Ability to work Monday-Friday, 8:30am-5:00pm EST • If working from home, cable broadband or fiber optic internet service with speeds of at least 10Mbps download/5Mbps upload

🏖️ 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 • Cable broadband or fiber optic internet service with minimum speeds of 10Mbps download/5Mbps upload for home workers