Evernorth Health Services, a division of The Cigna Group, is hiring an Eligibility Representative to support our CarepathRx team within Pharmacy and Care Delivery. In this role, you will help patients access care by providing clear, compassionate insurance verification and financial explanations so they can focus on their health with confidence.
What You'll Do
- Deliver accurate and timely insurance eligibility verification to support patient access to specialty pharmacy and infusion services
- Translate insurance benefits into clear cost estimates and coverage explanations for patients and care teams
- Create and maintain complete, accurate patient profiles, including demographics, insurance details, and authorization status
- Generate financial responsibility letters and review benefits with patients by phone in a supportive, easy-to-understand manner
- Secure prior authorizations and required payer documentation to prevent delays in care
- Coordinate financial assistance applications, payment agreements, and required waivers
- Monitor reimbursement activity, identify issues early, and assist with research to support resolution
- Collaborate with internal partners to ensure a seamless patient and client experience
- Maintain productivity, quality, and accuracy standards while managing multiple priorities
- Demonstrate accountability, follow-through, and pride in delivering reliable, high-quality work
- Contribute to continuous improvement by sharing insights and supporting efficient reimbursement workflows
What We're Looking For
- High school diploma or GED
- Minimum 1 year of experience in insurance verification, prior authorization, or related reimbursement work within a healthcare setting
- Working knowledge of medical terminology
- Proficient computer skills, including Microsoft Office products
- Strong math skills with attention to detail
- Clear written and verbal communication skills
- Strong organization and time management abilities
Nice to Have
- Experience navigating payer websites and eligibility systems
- Understanding of coordination of benefits
- Knowledge of pharmacy versus medical benefit payers
- Familiarity with prior authorization requirements and plan formularies
- Experience supporting specialty pharmacy or infusion services
Technical Stack
- Microsoft Office
Benefits & Compensation
- Compensation: 17.75 - 26 USD / hourly
- Comprehensive health-related benefits including medical, vision, dental, and well-being and behavioral health programs starting day one
- 401(k)
- Company paid life insurance
- Tuition reimbursement
- Minimum of 18 days of paid time off per year
- Paid holidays
- Annual bonus plan eligibility
Work Mode
This is a remote position.
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.
