Eligibility Representative

🔥 0 minutes ago

🎸 Tennessee – Remote

🎸 Tennessee – Remote

💵 $17 - $26 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

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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

• Perform medical/pharmacy benefit verification by contacting insurance companies or using provider portals • Facilitate cross-functional resolution of drug coverage issues • Research and resolve issues to support timely onboarding of specialty patients • Coordinate services to ensure reimbursement, including deductibles, copayments, effective dates, levels of care, and authorizations • Review insurance on the day of shipment to verify reimbursement criteria and reduce bad debt risk • Collaborate with internal departments to resolve issues and provide information • Handle patient or complex client complaints using discretion and independent judgment, escalating as appropriate • Complete other projects and assigned duties

🎯 Requirements

• High school diploma or GED required • Bachelor’s degree preferred • 2+ years of relevant working experience • Health care or professional office experience preferred • Knowledge of medical insurance and terminology preferred • Experience in patient access preferred • Pharmacy or specialty pharmacy experience is a plus • Proficiency in Microsoft Office products, including Word, Outlook, and Excel • Excellent written and oral communication skills • Ability to adapt in a dynamic work environment and make decisions with minimal supervision • Problem-solving skills • Ability to collaborate with other departments to resolve issues with innovative solutions • Cable broadband or fiber optic internet service with at least 10 Mbps download and 5 Mbps upload when working from home

🏖️ 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 (occasionally or permanently)