[Hiring] Eligibility Senior Representative @Cigna Healthcare

Role Description

Help patients and prescriber offices move through the access process with confidence. As an Eligibility Senior Representative on the phone queue, you will support specialty pharmacy services by answering inbound questions, explaining coverage and financial responsibility, and helping resolve issues that may delay therapy. This role is a great fit for someone who communicates clearly, solves problems with care, and wants to make a meaningful impact for patients.

• Support patients and prescriber offices through inbound calls related to insurance coverage, patient access, reimbursement support, and referral status.
• Review and confirm patient demographic, insurance, and referral information to help move referrals forward accurately and efficiently.
• Explain insurance benefits, copays, coinsurance, deductibles, and other financial responsibilities in a clear and professional way.
• Help patients understand available copay assistance, manufacturer assistance, and other financial support options.
• Identify barriers that may delay therapy, including insurance, authorization, financial, or coverage concerns, and help coordinate next steps toward resolution.
• Provide accurate updates on referral status, access requirements, and actions needed to support timely patient care.
• Manage escalated patient or prescriber concerns with professionalism, empathy, and sound judgment.
• Meet quality, productivity, and phone queue expectations while creating a positive caller experience.

Qualifications

• High school diploma or equivalent.
• Minimum of 1 year of experience in a phone queue, call center, healthcare, specialty pharmacy, patient access, reimbursement, insurance verification, customer service, or a related field.
• Strong verbal communication, customer service, and problem-solving skills.
• Ability to manage multiple priorities while maintaining accuracy and attention to detail.
• Comfort working in a fast-paced environment where patient needs and business priorities may shift throughout the day.

Requirements

• Must be able to work a Monday through Friday schedule between the hours of 9:00AM - 6:30PM EST.

Preferred Qualifications

• Experience conducting medical or pharmacy benefit investigations.
• Experience in specialty pharmacy, patient access, reimbursement support, or benefit investigation services.
• Knowledge of specialty drug reimbursement, copay assistance programs, and patient access support services.
• Experience working in a call center or phone queue environment.
• Experience discussing insurance benefits, copays, coinsurance, deductibles, and financial assistance options with patients.

Benefits

• Hourly rate of 19 - 29 USD / hourly, depending on relevant factors, including experience and geographic location.
• Eligible to participate in an annual bonus plan.
• Comprehensive range of health-related benefits including medical, vision, dental, and well-being and behavioral health programs.
• 401(k) and company paid life insurance.
• Tuition reimbursement.
• A minimum of 18 days of paid time off per year.
• Paid holidays and leaves of absence.