Senior Eligibility Representative
Location
Tennessee
Posted
3 days ago
Salary
0
Seniority
Senior
Job Description
Senior Eligibility Representative
The Cigna Group
• Perform specialized patient access functions requiring an advanced understanding of insurance benefits and processes • Communicate with Payers, Pharma, Physicians, and Patients • Recognize trends, identify and clarify patients’ needs, and work towards solutions • Facilitate cross-functional resolution of drug coverage issues & proactively address, research & resolve issues impacting referral turn-around time • Independently resolve basic patient claims issues using key subject matter knowledge • Prepare and review claims to ensure accuracy to payer requirements, including codes, dates, and authorizations • Collaborate with internal departments to resolve issues or provide information
Job Requirements
- High school diploma or GED required, bachelor’s degree preferred
- At least 2+ years of related working experience
- Must have Health care experience with medical insurance knowledge and terminology and experience in patient access
- Intermediate data entry skills and working knowledge of Microsoft Office
- Excellent phone presentation and communication skills
- Demonstrated ability to handle professionally challenging customers
- Ability to adapt in a dynamic work environment and make decisions with minimal supervision
- Advanced problem-solving skills and ability to work collaboratively with other departments to resolve issues with innovative solutions
Benefits
- Health care products and services
- Comprehensive management services including outcomes measurement, counseling, clinical care management programs, social services, and reimbursement services
- Opportunity to make a positive impact on patients’ lives
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