Eligibility Account Specialist - Remote

Cigna in; Bloomfield (CT); Remote; USD 60,000 - 80,000; Full time

Job summary

An established industry player is seeking dedicated Eligibility Account Specialists to enhance the health and vitality of those they serve. This remote role involves managing automated eligibility processes, collaborating with clients and vendors, and ensuring timely access to care. Ideal candidates will possess strong healthcare experience and a client-centric focus. This position offers a competitive hourly rate and a comprehensive benefits package, including health insurance, paid time off, and a 401(k) plan. Join a team committed to making a meaningful impact in the healthcare sector.

Benefits

Health Insurance

401(k) with Company Match

Tuition Reimbursement

Paid Time Off

Paid Holidays

Life Insurance

Qualifications

• 2+ years of health care experience with medical insurance terminology.
• Strong technical, problem solving and analytical skills are required.

Responsibilities

• Manage automated eligibility maintenance process for clients.
• Communicate ongoing eligibility status to partners and clients.

Skills

Health Care Experience

Medical Insurance Knowledge

Client/Customer Focus

Problem Solving Skills

Analytical Skills

Education

High School Diploma or GED

Tools

Salesforce

Facets

Electronic Data Interchange (EDI)

Job description

Eligibility Account Specialist - Remote (Finance)

Eligibility Account Specialist - Remote (Finance)

Do you want to improve the health and vitality of those we serve? The Cigna Group is hiring several Eligibility Account Specialists who will be responsible for all aspects of coordinating open enrollment files and file maintenance with automated eligibility processing. This also includes setups for clients who are switching vendors. This role will support clients specifically on the Facets platform that are managed on the Eligibility Services team within Client Operations .

What you'll do to make a difference

• Manage the end-to-end automated eligibility maintenance process for existing clients leveraging automated eligibility file feeds ensuring health of file and overall book of business
• Work with internal and external partners on completion of all documentation required for open enrollment process
• Load final files into production and generate reports to identify and resolve discrepancies
• Communicate ongoing automated eligibility status to internal and external partners
• Identify process improvement opportunities
• Drive results with third party vendors to ensure timely access to care for clients/customers
• Update all tracking tools, including Vista and Salesforce, with deliverables, completion dates and status of accounts

Requirements:

• High school Diploma or GED, required
• 2+ years of health care experience with medical insurance knowledge/terminology and experience in patient access preferred
• Exposure to Facets highly preferred
• Salesforce experience a plus
• Electronic data interchange (EDI)/eligibility is preferred
• Strong client/customer-centric focus and ability to work directly with clients, brokers and third-party vendors in a client-facing role
• Strong technical, problem solving and analytical skills
• Demonstrated ability to learn and apply knowledge
• Ability to manage multiple and divergent priorities
• Proficiency with multiple software and system-based applications
• Excellent communication, interpersonal and organizational skills

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 24 - 40 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: [e-mail] for support. Do not email [e-mail] 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.