Job Responsibilities : Eligibility Representative – Work from home, TN, MS- Accredo

Salary : $17 per hour

Company : Cigna

Location : Remote us

Educational requirements : High School

What you’ll do:
Facilitates 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 but not limited to codes, dates and authorizations

Effectively collaborate with internal departments to resolve issues or provide any needed information

Contact benefit providers to gather policy benefits/limitations

Coordinate and ensure services provided will be reimbursable (e.g., deductible amounts, co-payments, effective date, levels of care, authorization, etc.)

Perform medical/pharmacy benefit verification requiring complex decision skills based on payer and process knowledge

What you’ll need:
High school diploma or GED

3-5 years of relevant working experience

Experience with health care, medical insurance terminology and patient access preferred

Strong data entry skills and computer skills

Excellent phone presentation and communication skills

Demonstrated ability to handle difficult conversations in a professional manner

Ability to adapt in a dynamic work environment and make decisions independently

Advanced problem solving skills and the ability to work collaboratively with other departments

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