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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.
Prior Authorization Representative
Location
Florida + 4 moreAll locations: Florida | New Jersey | North Carolina | Pennsylvania | South Carolina
Posted
9 days ago
Salary
$17 - $26 / hour
Seniority
Junior
Job Description
Prior Authorization Representative
The Cigna Group
• Submit initial and renewal prior authorization requests through payer portals, phone, fax, or other approved methods. • Track open requests and follow up on time to help reduce delays in care. • Review information for accuracy and completeness before sending requests to insurance plans. • Work with clinicians and internal teams to gather documents needed to support authorization requests. • Share clear updates with patients, prescribers, and team members about approvals, denials, or next steps. • Respond to email, chat, and other requests in a timely and professional way. • Manage daily tasks and priorities while meeting team quality and productivity goals. • Keep patient information private and document work accurately.
Job Requirements
- High school diploma or GED.
- Minimum 1 year of experience in customer service, administrative support, healthcare support, insurance, call center, data entry, or a related role.
- Basic knowledge of medical terminology.
- Comfort using computers and Microsoft Office applications, including Outlook, Word, and Excel.
- Clear written and verbal communication skills.
- Strong attention to detail and ability to stay organized while managing multiple tasks.
- Customer-focused mindset and ability to work well with patients, providers, and internal teams.
- Ability to handle confidential patient information with care.
- Experience in healthcare, insurance verification, prior authorization, patient access, billing, pharmacy, home infusion, or durable medical equipment (DME) preferred.
- Familiarity with payer websites, insurance eligibility, coordination of benefits, formularies, denials, or appeals preferred.
Benefits
- Medical
- Vision
- Dental
- Well-being and behavioral health programs
- 401(k)
- Company paid life insurance
- Tuition reimbursement
- Minimum of 18 days of paid time off per year
- Paid holidays
- Leaves of absence
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