Cigna Jobs – Eligibility Representative

Job Description:

Express Scripts and Accredo are now part of Cigna. Together, we’ve got big plans. How big, you ask? We want to change health care to make it more affordable, more personalized, and more focused on helping the whole person to achieve better health outcomes. And that’s only the beginning. Read on to learn more about working with us.

As an Eligibility Representative, you will be part of a team passionate about helping our patients with billing and ensuring their access to life saving medications.

Job Responsibilities:

• Coordinate and ensure services provided will be reimbursable (e.g., deductible amounts, co-payments, effective date, levels of care, authorization, etc.)
• Contact benefit providers to gather policy benefits/limitations
• Facilitates cross-functional resolution of drug coverage issues & proactively address, research & resolve issues impacting referral turn-around time
• Effectively collaborate with internal departments to resolve issues or provide any needed information
• Prepare and review claims to ensure accuracy to payer requirements, including but not limited to codes, dates and authorizations
• Independently resolve basic patient claims issues using key subject matter knowledge
• Perform medical/pharmacy benefit verification requiring complex decision skills based on payer and process knowledge

Qualification & Experience:

• Strong data entry skills and computer skills
• Excellent phone presentation and communication skills
• Experience with health care, medical insurance terminology and patient access preferred
• Demonstrated ability to handle difficult conversations in a professional manner
• Advanced problem solving skills and the ability to work collaboratively with other departments
• High school diploma or GED
• Ability to adapt in a dynamic work environment and make decisions independently
• 3-5 years of relevant working experience

Job Details:

Company: Cigna

Vacancy Type:  Full Time

Job Location: Charlotte, NC, US

Application Deadline: N/A

Apply Here

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