Address
Form of work
Salary**Remote opportunity
**Schedule: Monday - Friday between 8:00AM - 5:00PM EST
Role Summary
The Eligibility Analyst Senior Representative is responsible for the maintenance of complex manual and electronic eligibility data for benefits, reconciles accounts for non-standard requests and assists other teammates with questions through their extensive technical and procedural knowledge. This is a critical role in providing world class customer service to the assigned portfolio of global clients that he/she manages.
Responsibilities
Manage external client requests via telephone or email to update manual/electronic eligibility data; Independently respond to inquiries from our internal business partners through our Customer Relationship Management tool and Microsoft Outlook regarding eligibility data updates or inconsistencies; Complete all requests within established quality and turnaround time standards
Perform research to identify and resolve inconsistencies in eligibility data through individual analysis, reporting and client feedback
Identifies process improvement opportunities for assigned clients and other department wide initiatives
Independently interact with external clients and vendors through written communication (email and letters), telephone conferences, reporting and client visits
Work with internal business partners to resolve technical issues and identify process improvement opportunities
May be a business process owner (i.e. ID cards or Online Enrollment)
Additional responsibilities may as assigned by manager
Expectations
Contribute towards the business's Net Promoter Score goal by meeting or exceed established goals related to accuracy, timeliness and productivity
Provide, accept and act on performance feedback from peers, business partners, external clients/vendors, leadership and customer survey results
Demonstrate the ability to learn and effectively apply new skills and techniques as client demands constantly change
Acts with customers in mind
Communicate with all necessary internal and external business partners in a professional manner in a variety of communication styles (i.e. e-mail, telephone, etc.)
Must leverage the following competencies to drive our customer centric business strategy:
Customer Focus
Dealing with Ambiguity
Interpersonal Savvy
Learning and Applying Quickly
Priority Setting
Problem Solving
Qualifications
High School Diploma or GED required. Bachelor’s degree preferred.
2+ years of experience in the Healthcare Industry, Pharmacy, or PBM highly preferred.
Diamond system experience highly preferred
Client facing experience a plus
Professional and Detail Oriented
Strong Customer Focus and Service Oriented
Excellent Interpersonal Skills
Requires Excellent Written and Verbal Communication Skills
Excellent Telephone Etiquette
Strong Analytical Skills
Critical Thinker
Good Organizational and Problem Solving Skills
Self-starter and Problem Solver
Excellent Time Management Skills
Ability to Learn Quickly
Ability to work independently and in a team environment
General Knowledge of Microsoft Office Suite (Proficient in Excel)
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 18 - 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 Cigna Healthcare
Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. 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: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com 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.
