The Cigna Group Eligibility Lead Representative – Accredo – Remote in Bloomfield, Connecticut

December 2, 2023

Job Description


Must live in Missouri, within commuting distance to 4600 N. Hanley, St. Louis, MO and able to work a shift between 7am to 8pm CST, Monday-Friday.*

Want to Drive Growth and Improve Lives? The Cigna Group is hiring several Eligibility Lead Representatives. For this demanding role, you’ll ensure our patients receive prescription insurance coverage for their very specialized medication. You’ll manage back-to-back; inbound and outbound calls collaborating with insurance providers, doctors’ offices and patients gathering information to ultimately obtain insurance coverage. Your persistence and continuous follow up will ensure our patients to receive this vital medication in a timely manner.

How you’ll make a difference:

  • Use your knowledge of the healthcare industry, Prescription Benefit Programs, pharmacy coverage, Reimbursement and Insurance processes to ensure patients get their specialty medication.

  • Manage constant inbound and outbound calls exemplifying the highest customer service standards to meet quality and production metrics

  • Use your advanced technical skills to navigate through multiple systems, applications and screens simultaneously all while speaking on the phone.

  • Use your independent judgement in managing escalated patient or client complaints and discretion to escalate further if needed

What you’ll need to be a success:

  • High school diploma or GED required

  • 2+ years of experience with Prescription Benefit Programs, Pharmacy Coverage, Prior Authorization, Eligibility or Insurance processes required

  • 2+ years of experience in healthcare, medical terminology, CPT and ICD codes required

  • Proficiency with Microsoft Office products (Word, Outlook, Excel) required

  • Pharmacy Technician experience or license preferred

What you’ll love about working here:

  • 1st day benefits; Medical Dental & Vision and more

  • 18 days Paid Time Off & 8 Paid Holidays

  • Performance bonus

  • Annual Merit increase

  • Employer Contributions for HRA and HSA accounts

  • 401K with Company Match

  • Tuition Assistance

  • Advancement opportunities

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

For this position, we anticipate offering an hourly rate of 19 – 28 USD / hourly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group .

About Evernorth Health Services

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.

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.

If you require reasonable accommodation in completing the online application process, please email: [email protected] for support. Do not email [email protected] for an update on your application or to provide your resume as you will not receive a response.

The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.









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