Eligibility Representative

Job Description:

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 such as HIV, rheumatoid arthritis, and cancer. This role handles each inquiry with care, detail, and most importantly, empathy.

Here’s a little more on how you’ll make a difference:

Responsibilities

• Help patients get the medication they need. Use the knowledge you gain from training, your problem-solving skills and support from your team to coordinate and ensure services are covered under insurance coverage.

• Interact directly with plan providers. You’ll research and solve issues on benefits coverage with pharmacist and doctors’ offices.

• Juggle multiple tasks without sacrificing attention to detail. You will be busy handling multiple requests at any given time as well as documenting information from your conversations in our computer system.

Qualifications

• Previous Customer Service experience

• Health care experience with knowledge of medical insurance and terminology is preferred and will make you successful in this role!

• General PC knowledge including experience working with Microsoft Office

• Excellent communication skills (verbal and written)

Requirements

• High School Diploma / GED required, a bachelor’s degree is preferred.

• Must have reliable internet connectivity through a wired internet connection. (Hot spots or mobile internet are not allowed)

• Must have a private dedicated workspace that is free of distractions.

• Availability to attend 100% of training within the first 90 days of employment.

Why you’ll love working here

• Fun, friendly, and unique culture – Bring your whole self to work every day!

• Choice of 3 unique medical plans

• Prescription Drug, Dental, Vision, and Life Insurance

• Employee contributions for HRA and HSA accounts

• 401K with Company Match

• Paid Time Off and Paid Holidays

• Tuition Assistance

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

About Evernorth Health Services: Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives.