United States onlyThe Eligibility Senior Representative is responsible for providing service for Eligibility and Compliance related issues. Responds to inquiries from members, clients, and internal/external matrix partners. Accountable partnering with internal and external partners to create positive client experience.
What You’ll Do:
Receive requests via telephone and email regarding eligibility and compliance related requests
Respond and accurately resolve eligibility inquiries from clients, brokers, third party vendors as well as internal and external business partners
Properly adhere to policies, procedures, state requirements and resources
Perform necessary updates in eligibility systems, Structure tools to correct data discrepancies or any type of manual update needed
Interacts with internal and/or external partners
Work with Members, Client, Implementation, and Service Partners to resolve eligibility issues
Requirements:
High School diploma or GED, Required, bachelor’s degree, preferred
2 + years of experience in customer service, with ability to negotiate and manage expectations for mutually acceptable solutions, highly preferred
2 + years of experience researching and analyzing eligibility and/or claims related issues, highly preferred
Proficient with Microsoft Office products, (Excel, Outlook, Word), required
Ability to navigate multiple systems / platforms while researching data, highly preferred
1 + years of experience with Salesforce, preferred
Ability to manage multiple and divergent priorities and deadlines, preferred
Work Schedule – 8:30 am to 5:00 P.M. Eastern Standard Time, required
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.For this position, we anticipate offering an hourly rate of 19 - 28 USD / hourly, depending on relevant factors, including experience and geographic location.
This role is also anticipated to be eligible to participate in an annual bonus plan.
We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group.
About The Cigna Group
Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives.Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
If you require reasonable accommodation in completing the online application process, please email: [email protected] for support. Do not email [email protected] for an update on your application or to provide your resume as you will not receive a response.
The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
