Senior Eligibility Representative

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $19 - $29 / hour

⏰ Full Time

🟠 Senior

👻 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

• Facilitate cross-functional resolution of drug coverage issues • Proactively address, research, and resolve issues affecting referral turnaround time • Independently resolve basic patient claims issues • Prepare and review claims for accuracy and payer compliance, including codes, dates, and authorizations • Collaborate with internal departments to resolve issues and provide information • Contact benefit providers to gather policy benefits and limitations • Perform complex medical/pharmacy benefits verification based on payer and process knowledge • Complete other assigned projects and duties • Communicate updates on pending referrals that may affect the patient experience • Recognize trends, clarify patient needs, and develop solutions to improve the patient experience

🎯 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 • 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 • For home-based work, cable broadband or fiber optic internet service with 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 • Remote work arrangement • Cable broadband or fiber optic internet requirement for work-at-home employees