Prior Authorization Representative

Job not on LinkedIn

🔥 3 minutes ago

🐊 Florida, New Jersey, +4 more states – Remote

🐊 Florida – Remote 🏖️ New Jersey – Remote 🌲 North Carolina – Remote 🔔 Pennsylvania – Remote 🌴 South Carolina – Remote 🍑 Georgia – 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

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

• Submit initial and renewal prior authorization requests through payer portals, phone, fax, or other approved methods • Track open requests and follow up on time to help reduce delays in care • Review information for accuracy and completeness before sending requests to insurance plans • Work with clinicians and internal teams to gather documents needed to support authorization requests • Share clear updates with patients, prescribers, and team members about approvals, denials, or next steps • Respond to email, chat, and other requests in a timely and professional way • Manage daily tasks and priorities while meeting team quality and productivity goals • Keep patient information private and document work accurately • Support CarepathRx within Evernorth Health Services’ Pharmacy and Care Delivery organization, focused on specialty pharmacy and infusion services

🎯 Requirements

• High school diploma or GED • Minimum 1 year of experience in customer service, administrative support, healthcare support, insurance, call center, data entry, or a related role • Basic knowledge of medical terminology • Comfort using computers and Microsoft Office applications, including Outlook, Word, and Excel • Clear written and verbal communication skills • Strong attention to detail and ability to stay organized while managing multiple tasks • Customer-focused mindset and ability to work well with patients, providers, and internal teams • Ability to handle confidential patient information with care • Preferred: Experience in healthcare, insurance verification, prior authorization, patient access, billing, pharmacy, home infusion, or durable medical equipment (DME) • Preferred: Familiarity with payer websites, insurance eligibility, coordination of benefits, formularies, denials, or appeals • Preferred: Experience working in a fast-paced team environment where accuracy and follow-up are important • For work at home, cable broadband or fiber optic internet service with at least 10Mbps download/5Mbps upload

🏖️ Benefits

• Annual bonus plan eligibility • Medical, vision, and dental benefits • Well-being and behavioral health programs • 401(k) • Company-paid life insurance • Tuition reimbursement • Minimum 18 days of paid time off per year • Paid holidays • Leaves of absence • Reasonable accommodation support for the application process

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