Eligibility Representative – Evernorth - Remote

Eligibility Representative

We’re looking for a detail-oriented team player to support our patient intake process. This role involves managing referrals, ensuring accurate data entry, and providing excellent customer service to patients and internal teams.

Schedule: Monday-Friday, 10:30am-7pm ET (rotating weekend days and holidays)

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.

Key Responsibilities

• Collect and document referral information via fax, email or electronic medical record portal.
• Answer incoming calls related to referrals.
• Enter new patient and referral source details into the system.
• Notify intake coordinator of pending referrals.
• Assist with phone communication and clerical tasks as needed.
• Maintain confidentiality and accuracy in all processes.
• Perform other duties as assigned.

Requirements

• High school diploma or GED.
• 1+ year of insurance verification, prior authorization, or related experience in a pharmacy or healthcare setting.
• Knowledge of medical terminology.
• Strong computer skills and familiarity with MS Office.
• Ability to prioritize and manage multiple tasks effectively.

As part of Evernorth Health Services, this role supports CarepathRx within

our Pharmacy and Care Delivery organization. Our team focuses on

specialty pharmacy and infusion services in partnership with hospitals and

health systems.

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.

Skills & Abilities

• Strong customer service focus and teamwork.
• Excellent verbal and written communication skills.
• Proficient in Microsoft Office (Outlook, Word, Excel).
• Organized, detail-oriented, and able to multitask.