Senior Eligibility Representative

🔥 1 minute ago

🇺🇸 United States – Remote

💵 $19 - $29 / hour

⏰ Full Time

🟠 Senior

👻 Ghost score 0%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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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

• Facilitate cross-functional resolution of drug coverage issues • Proactively address, research, and resolve issues impacting referral turnaround time • Independently resolve basic patient claims issues using subject matter knowledge • Prepare and review claims for accuracy and alignment with payer requirements, including codes, dates, and authorizations • Collaborate with internal departments to resolve issues and provide needed information • Contact benefit providers to gather policy benefits and limitations • Perform medical/pharmacy benefits verification requiring complex decision-making based on payer and process knowledge • Complete other projects and additional duties as assigned

🎯 Requirements

• High school diploma or GED required • At least 2+ years of related working experience • Healthcare experience with medical insurance knowledge and terminology • Experience in patient access • Intermediate data entry skills • Working knowledge of Microsoft Office • Excellent phone presentation and communication skills • Demonstrated ability to professionally handle challenging customer situations • Ability to adapt in a dynamic work environment and make decisions with minimal supervision • Advanced problem-solving skills • Ability to work collaboratively with other departments to resolve issues with innovative solutions • For home working, internet service must be obtained through a cable broadband or fiber optic provider 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 connection requirement for home working, with at least 10Mbps download/5Mbps upload

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