Eligibility Lead Representative, ESSDS - Accredo - Remote

Cigna in; Bloomfield (CT); Remote; USD 80,000 - 100,000; Full time

Job summary

A healthcare solutions provider is seeking an Eligibility Lead Representative to assist patients with medication insurance coverage. The ideal candidate should have strong customer service skills, knowledge of the healthcare industry, and be proficient in technical systems. This remote role offers an hourly rate of $21 to $31, with opportunities for bonuses and comprehensive health benefits from the first day of employment.

Benefits

Health insurance

401(k) with company match

Tuition reimbursement

Paid time off

Qualifications

• Must have 1+ years of customer service experience.
• Pharmacy Technician experience or license is highly preferred.
• Proficiency with Microsoft Office products required.

Responsibilities

• Ensure patients receive prescription insurance coverage.
• Manage inbound and outbound calls to meet customer service standards.
• Navigate multiple systems while assisting patients.

Skills

Customer service

Healthcare knowledge

Technical skills

Communication

Education

High school diploma or GED

Tools

Microsoft Office

Job description

Eligibility Lead Representative, ESSDS - Accredo - Remote (Finance)

Accredo, a specialty pharmacy line of business within The Cigna Group, is hiring several Eligibility Lead Representatives. For this demanding customer centric role, you\'ll ensure our patients receive prescription insurance coverage for their medication. You\'ll handle continuous inbound and outbound calls, navigating multiple technical systems and platforms while gathering information from insurers, doctors, and patients to secure coverage. Your persistence and continuous follow-up will ensure our patients receive this vital medication in a timely manner.

Must be able to work any shift between 7am to 8pm CST, Monday-Friday

What You\'ll Do:

• Use your knowledge of the healthcare industry, Prescription Benefit Programs, pharmacy coverage, Reimbursement and Insurance processes to ensure patients get their specialty medication
• Manage constant inbound and outbound calls exemplifying the highest customer service standards to meet quality and production metrics
• Use your advanced technical skills to navigate through multiple systems, applications, platforms and screens simultaneously all while speaking on the phone
• Use your independent judgement in managing escalated patient or client complaints and discretion to escalate further if needed

What you\'ll need:

• High school diploma or GED - Required
• 1+ years of customer service experience - Required
• Pharmacy Technician experience or license, Highly preferred
• 2+ years of experience with Prescription Benefit Programs, Pharmacy Coverage, Prior Authorization, Eligibility or Insurance processes, Preferred
• 2+ years of experience in healthcare, medical terminology, CPT and ICD codes - Preferred
• Proficiency with Microsoft Office products (Word, Outlook, Excel) and technical savvy navigating multiple systems and platforms - Required
• Able to work any shift between 7am to 8pm CST, Monday-Friday - Required

REQUIREMENT: For those that reside in Missouri, this position requires that the applicant successfully complete registration with the Missouri State Board of Pharmacy as a pharmacy technician. This process includes a criminal background check, fingerprinting, and a review of the last three years of state income tax filings. Additional information about these requirements can be found at https://pr.mo.gov/boards/pharmacy/375-0408.pdf.

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 21 - 31 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 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.

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.