Eligibility Representative - Accredo - Remote

The Cigna Group

7h • $17 - $26 • Remote

About The Position

The job profile for this position is Eligibility Representative, which is a Band 1 Professional Career Track Role. This role handles each inquiry with care, detail, and most importantly, empathy. As an Eligibility Representative, you’ll be part of a dedicated team which helps our specialty pharmacy patients coordinate their medication needs and pharmacy insurance coverage for complex medical conditions.

Requirements

• High school diploma or GED required
• 2+ years of relevant working experience.
• Health care or professional office experience with medical insurance knowledge and terminology and experience in patient access preferred.
• Pharmacy/Specialty pharmacy experience a plus
• Proficient in Microsoft Office Products- Word, Outlook, Excel
• Excellent communication skills, including written, and oral phone presentation.
• Ability to adapt in a dynamic work environment and make decisions with minimal supervision.
• Problem solving skills and the ability to work collaboratively with other departments to resolve issues with innovative solutions.
• internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

Nice To Haves

• bachelor’s degree preferred.
• Health care or professional office experience with medical insurance knowledge and terminology and experience in patient access preferred.
• Pharmacy/Specialty pharmacy experience a plus

Responsibilities

• Performs medical/pharmacy benefit verification by contacting insurance company or using provider portals for drug coverage and benefits.
• Facilitates cross-functional resolution of drug coverage issues & proactively address, researches & resolves issues resulting in timely onboarding of specialty patients
• Coordinating and ensuring services provided will be reimbursable (e.g., deductible amounts, co-payments, effective date, levels of care, authorization, etc.).
• Perform insurance review on day of shipment to ensure insurance criteria is met for reimbursement and reduce the risk of bad debt
• Effectively collaborates with internal departments to resolve issues or provide any needed information using professional communication at all times.
• Use discretion & independent judgement in handling patient or more complex client complaints, escalating to leadership as appropriate.
• Completes other projects and additional duties as assigned.

Benefits

• medical
• vision
• dental
• well-being and behavioral health programs
• 401(k)
• company paid life insurance
• tuition reimbursement
• a minimum of 18 days of paid time off per year
• paid holidays
• leaves of absence
• annual bonus plan

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED