Senior Eligibility Representative

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🎸 Tennessee – Remote

🎸 Tennessee – Remote

⏰ Full Time

🟠 Senior

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The Cigna Group

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1982

⚕️ Healthcare Insurance

💊 Pharmaceuticals

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 specialized patient access functions requiring an advanced understanding of insurance benefits and processes • Communicate with Payers, Pharma, Physicians, and Patients • Recognize trends, identify and clarify patients’ needs, and work towards solutions • Facilitate cross-functional resolution of drug coverage issues & proactively address, research & resolve issues impacting referral turn-around time • Independently resolve basic patient claims issues using key subject matter knowledge • Prepare and review claims to ensure accuracy to payer requirements, including codes, dates, and authorizations • Collaborate with internal departments to resolve issues or provide information

🎯 Requirements

• High school diploma or GED required, bachelor’s degree preferred • At least 2+ years of related working experience • Must have Health care experience with medical insurance knowledge and terminology and experience in patient access • Intermediate data entry skills and working knowledge of Microsoft Office • Excellent phone presentation and communication skills • Demonstrated ability to handle professionally challenging customers • Ability to adapt in a dynamic work environment and make decisions with minimal supervision • Advanced problem-solving skills and ability to work collaboratively with other departments to resolve issues with innovative solutions

🏖️ Benefits

• Health care products and services • Comprehensive management services including outcomes measurement, counseling, clinical care management programs, social services, and reimbursement services • Opportunity to make a positive impact on patients’ lives