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Eligibility Senior Representative - Remote

The Cigna Group
New Hampshire Work at Home, United States, United StatesRemotefull_timeVerifiedPosted 27 May 2025

About the role

The Eligibility Senior Representative is responsible for providing service for Eligibility and Compliance related issues. Responds to inquiries from members, clients, and internal/external matrix partners. Accountable partnering with internal and external partners to create positive client experience.

What You’ll Do:

  • Receive requests via telephone and email regarding eligibility and compliance related requests

  • Respond and accurately resolve eligibility inquiries from clients, brokers, third party vendors as well as internal and external business partners

  • Properly adhere to policies, procedures, state requirements and resources

  • Perform necessary updates in eligibility systems, Structure tools to correct data discrepancies or any type of manual update needed

  • Interacts with internal and/or external partners

  • Work with Members, Client, Implementation, and Service Partners to resolve eligibility issues

Requirements:

  • High School diploma or GED, Required, bachelor’s degree, preferred

  • 2 + years of experience in customer service, with ability to negotiate and manage expectations for mutually acceptable solutions, highly preferred

  • 2 + years of experience researching and analyzing eligibility and/or claims related issues, highly preferred

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

  • Ability to navigate multiple systems / platforms while researching data, highly preferred

  • 1 + years of experience with Salesforce, preferred

  • Ability to manage multiple and divergent priorities and deadlines, preferred

  • Work Schedule – 8:30 am to 5:00 P.M. Eastern Standard Time, required


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 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

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Company

The Cigna Group

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