Eligibility Representative, Specialty

🔥 1 minute ago

🇺🇸 United States – Remote

💵 $17 - $26 / hour

⏰ Full Time

🟢 Junior

🚫👨‍🎓 No degree required

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.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

Founded 1982

🏥 Healthcare

⚕️ Healthcare Insurance

💊 Pharmaceuticals

Healthcare • Healthcare Insurance • Pharmaceuticals

The Cigna Group is a global health company committed to improving the health and vitality of its clients, customers, and patients. With its two divisions, Cigna Healthcare and Evernorth Health Services, the company focuses on enhancing quality of life through healthcare services and pharmacy benefits management. The Cigna Group is dedicated to ethical practices in healthcare and artificial intelligence, and strives to create positive change in the healthcare system. It also emphasizes its Environmental, Social, and Governance (ESG) responsibilities, aiming to impact health equity and foster innovation in healthcare delivery.

📋 Description

• Verify patient insurance coverage, calculate estimated costs, and document details in patient profiles • Enter and update patient demographics in the system • Generate coverage and financial responsibility quotes and review benefits with patients by phone • Track, monitor, and secure required insurance and reimbursement documents • Obtain prior authorizations and 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 • Support specialty pharmacy and infusion services in partnership with hospitals and health systems

🎯 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 vs. medical payers and authorization processes preferred • Familiarity with plan formularies and authorization requirements preferred • Cable broadband or fiber optic internet service with at least 10Mbps download/5Mbps upload for home-based work

🏖️ Benefits

• Annual bonus plan eligibility • Medical, vision, and dental benefits starting on day one • 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 • Internet connection requirement supported through cable broadband or fiber optic service with at least 10Mbps download/5Mbps upload