Senior Patient Access & Benefits Specialist

Cigna; United States; Hybrid; USD 26,000 - 40,000; Full time

Benefits offered by this job

Annual bonus plan

Medical, vision, dental benefits

401(k)

Life insurance

Tuition reimbursement

Paid time off

Paid holidays

Leaves of absence

Job summary

The Cigna Group is seeking an Eligibility Senior Representative to help patients navigate access to medications, leveraging advanced understanding of benefits and payer processes. You will resolve drug coverage issues, verify benefits, and collaborate with internal teams to ensure timely patient experiences.

This role offers a comprehensive benefits package, an annual bonus plan, and the opportunity to work in a flexible hybrid/remote setup if needed.

Qualifications

• High school diploma or GED required.
• At least 2+ years of related working experience.
• Healthcare experience with medical insurance knowledge and terminology, along with experience in patient access.
• Intermediate data entry skills and working knowledge of Microsoft Office.
• Excellent phone presentation and communication skills.
• Demonstrated ability to professionally handle challenging customer situations.
• Ability to adapt in a dynamic work environment and make decisions with minimal supervision.
• Advanced problem-solving skills and the ability to work collaboratively with other departments to resolve issues with innovative solutions.

Responsibilities

• Facilitate cross-functional resolution of drug coverage issues and proactively address, research, and resolve issues impacting referral turnaround time.
• Independently resolve basic patient claims issues using key subject matter knowledge.
• Prepare and review claims to ensure accuracy and alignment with payer requirements, including but not limited to codes, dates, and authorizations.
• Effectively collaborate with internal departments to resolve issues or provide needed information, always using professional communication.
• Contact benefit providers to gather policy benefits and limitations.
• Perform medical/pharmacy benefits verification requiring complex decision-making skills based on payer and process knowledge.
• Complete other projects and additional duties as assigned.

Skills

Healthcare experience

Phone communication

Data entry

Problem solving

Collaborate cross-department

Education

High school diploma

Tools

Microsoft Office

Job description

The Cigna Group is seeking an Eligibility Senior Representative to help patients navigate access to medications, leveraging advanced understanding of benefits and payer processes. You will resolve drug coverage issues, verify benefits, and collaborate with internal teams to ensure timely patient experiences.

This role offers a comprehensive benefits package, an annual bonus plan, and the opportunity to work in a flexible hybrid/remote setup if needed.