Eligibility Representative

🔥 0 minutes ago

🎸 Tennessee – Remote

🎸 Tennessee – Remote

💵 $17 - $26 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

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

• 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 • Perform insurance reviews on the day of shipment to confirm reimbursement criteria and reduce bad debt risk • Collaborate with internal departments to resolve issues and provide needed information • Handle patient and complex client complaints using discretion and independent judgment, escalating to leadership as appropriate • Complete other projects and additional duties as assigned

🎯 Requirements

• High school diploma or GED required • Bachelor’s degree preferred • 2+ years of relevant working experience • Health care or professional office experience with medical insurance knowledge and terminology preferred • Experience in patient access preferred • Pharmacy or specialty pharmacy experience is a plus • Proficiency in Microsoft 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 and ability to collaborate with other departments • Cable broadband or fiber optic internet connection with at least 10 Mbps download and 5 Mbps upload for home working

🏖️ 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