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Added 14 mins ago
Eligibility Representative - Remote
Cigna-Evernorth Services Inc.
Remote, United States
Added 4 hours ago
Automation Engineer Sr. Analyst (Electrical Mechanical Technician) - Express Scripts - Onsite
Cigna-Evernorth Services Inc.
Whitestown, IN
Added 4 hours ago
Third Party Management Senior Advisor - Global Technology Products & Services - Hybrid
Cigna-Evernorth Services Inc.
Bloomfield, CT · Philadelphia, PA · Franklin, TN · St. Louis, MO
Added 16 hours ago
Prior Authorization Representative- Evernorth- Remote
Cigna-Evernorth Services Inc.
Remote, United States
Added 16 hours ago
Clinical Program Senior Advisor - Remote - Express Scripts (Academic Detailing)
Cigna-Evernorth Services Inc.
Remote, United States
Current pharmacist license required; relevant PBM, managed care, health plan, provider engagement, or clinical program experience preferred
Added 1 day ago
Business Communications Senior Advisor - Pharmacy and Care Delivery
Cigna-Evernorth Services Inc.
St. Louis, MO · Bloomfield, CT
Added 1 day ago
Senior Medical Cost Analytics Advisor (Remote)
Cigna-Evernorth Services Inc.
Remote, United States
Added 1 day ago
Staff Pharmacist - Evernorth - Remote - Per Diem (Remote Order Verification)
Cigna-Evernorth Services Inc.
Remote, United States
Pharmacists must hold an active license in each required state before providing coverage
Added 2 days ago
Government Affairs Principal- Midwest
Cigna-Evernorth Services Inc.
Remote, United States
Added 2 days ago
CS
Part-Time After Hours Staff Pharmacist - Remote (IL, IN, MO, KS, IA)
Cigna-Evernorth Services Inc.
Remote, United States
- Part-time
Licensure Requirements: Must have active licensure in any of these 5 states (IL, IN, KS, MO, IA) · At least 1 year of hospital pharmacy experience required
Added 2 days ago
Executive Assistant- Human Resources - Hybrid
Cigna-Evernorth Services Inc.
St. Louis, MO
Added 2 days ago
Insurance Risk Management Senior Analyst - Hybrid
Cigna-Evernorth Services Inc.
Philadelphia, PA
Added 3 days ago
Billing & Reimbursement Senior Representative - Whitestown, Indiana, USA
Cigna-Evernorth Services Inc.
Remote, United States
The qualified candidate must have a complete understanding of the billing and collection processes and require little supervision for routine work
Added 6 days ago
Lead Facilities Senior Supervisor
Cigna-Evernorth Services Inc.
MA
Universal CFC certification required
Added 6 days ago
Infrastructure Engineering Advisor
Cigna-Evernorth Services Inc.
Bloomfield, CT
Added 6 days ago
Health and Clinical Outcomes Research Intern (Master's/PhD Students)
Cigna-Evernorth Services Inc.
Bloomfield, CT
Added 7 days ago
Pharmacy Technician Representative - Advent Health - Thonotosassa, FL - 2nd Shift
Cigna-Evernorth Services Inc.
Thonotosassa, FL
Added 7 days ago
Audit Specialist II - Home Infusion - CarepathRx - Remote
Cigna-Evernorth Services Inc.
Remote, United States
Added 8 days ago
Client Solutions Strategist- Evernorth- Remote
Cigna-Evernorth Services Inc.
Remote, United States
Added 8 days ago
Patient Care Coordinator- Evernorth- Oakdale, PA
Cigna-Evernorth Services Inc.
Oakdale, PA
Added 8 days ago
CS
Patient Care Coordinator (Part-Time) - Evernorth- Oakdale, PA
Cigna-Evernorth Services Inc.
Oakdale, PA
- Part-time
Added 9 days ago
Internal Audit – Technology Audit & Analytics Advisor - Hybrid
Cigna-Evernorth Services Inc.
Bloomfield, CT · Franklin, TN · St. Louis, MO
Added 9 days ago
Counsel –AI & Technology
Cigna-Evernorth Services Inc.
Remote, United States
Added 10 days ago
Dedicated Client Service Partner, DCSP - ONSITE - St. Louis, MO - Cigna Healthcare - Remote
Cigna-Evernorth Services Inc.
United States
Required Onsite 5 days per week
Added 10 days ago
Architecture Principal - Platform Infrastructure
Cigna-Evernorth Services Inc.
Morris Plains, NJ · Bloomington, MN · Bloomfield, CT

Cigna-Evernorth Services Inc.

Eligibility Representative - Remote

Remote, United States

$17.75 to $26 USD / hour

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Job details

Pay: $17.75 to $26 USD / hour
Education: High school diploma
Posting language: English
Posted: Nov 12, 2026

Original job description

As an Eligibility Representative at Accredo, you will be part of a team passionate about helping our patients with billing and ensuring their access to life saving medications. This role helps our specialty pharmacy patients coordinate their medication needs and pharmacy insurance coverage for complex medical conditions such as HIV, rheumatoid arthritis and cancer. This role is on the front lines with patients and doctors offices, responding to phone inquiries and addressing each with care, detail, and most importantly, empathy.

What you’ll do:

Deliver straightforward administrative and/or other basic business services in Eligibility
Implement and maintain eligibility for benefits
Implement, update, and maintain automated, direct connect and/or manual eligibility data
Interact with internal partners and/or external clients/vendors
Generate reports to identify and resolve discrepancies
Identify process improvement opportunities for own cases
Negotiate and resolve eligibility with clients
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 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
Provide technical support for the electronic processing of eligibility
Ensure customer data is installed accurately and timely
Work with client's format and internal systems to resolve errors
Interact with systems to resolve technical issues

What you’ll need to do the job:

Must be able to work an 8 hour shift within the hours of 7am - 6pm EST (Mon - Fri)
High school diploma or GED required
1+ years of relevant working experience - customer service, billing, healthcare, pharmacy, insurance industry preferred
Experience with healthcare, medical insurance terminology and patient access preferred
General knowledge & understanding of manual and automated eligibility
General PC knowledge including experience working with Microsoft Office, Excel, Teams, SharePoint, PowerPoint
Familiar with reporting tools and/or RX Home, Copay Assistance, or CSP experience a plus
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
Works to clearly defined procedures under close supervision

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 17.75 - 26 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.

At The Cigna Group, 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), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year, paid holidays, and leaves of absence. For more details on our employee benefits programs, click here.

About The Cigna Group

Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. 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 need a reasonable accommodation to complete the online application process, please email seeyourself@thecignagroup.com for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.

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.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

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