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Senior Eligibility Representative
The Cigna GroupEligibility Senior Representative answering coverage and referral questions for Evernorth’s specialty pharmacy services. Explaining benefits, financial responsibility, and assistance options to support timely patient therapy.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in patient access and reimbursement support, with strong capabilities in insurance verification and financial assistance options. Proficient in managing patient inquiries and concerns while maintaining high-quality service standards in a fast-paced environment.
Highest-signal resume keywords
Patient Access SupportInsurance VerificationReimbursement SupportCustomer ServiceProblem-Solving
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Insurance Benefits ExplanationCopay Assistance KnowledgeReferral Status ManagementFinancial Responsibility UnderstandingPatient Demographic Review
Soft Skills
Strong Verbal CommunicationAttention to DetailMulti-Priority ManagementPositive Caller Experience
Tools & Technologies
Call Center SoftwarePhone Queue Management
Industry Keywords
Specialty PharmacyHealthcarePatient AccessReimbursementBenefit Investigation
About the role
Key responsibilities & impact- 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
- Explain insurance benefits, copays, coinsurance, deductibles, and other financial responsibilities
- Help patients understand copay assistance, manufacturer assistance, and other financial support options
- Identify therapy-delay barriers and coordinate next steps toward resolution
- Provide updates on referral status, access requirements, and actions needed for timely patient care
- Manage escalated patient or prescriber concerns
- Meet quality, productivity, and phone queue expectations while creating a positive caller experience
Requirements
What you’ll need- 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 related field
- Must be able to work Monday through Friday between 9:00 AM and 6:30 PM EST
- 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 with shifting patient needs and business priorities
- Preferred: experience conducting medical or pharmacy benefit investigations
- Preferred: experience in specialty pharmacy, patient access, reimbursement support, or benefit investigation services
- Preferred: knowledge of specialty drug reimbursement, copay assistance programs, and patient access support services
- Preferred: call center or phone queue experience
- Preferred: experience discussing insurance benefits and financial assistance options
- Home internet must be cable broadband or fiber optic with at least 10Mbps download/5Mbps upload when working from home
Benefits
Comp & perks- Annual bonus plan eligibility
- Medical benefits
- Vision benefits
- Dental benefits
- Well-being and behavioral health programs
- 401(k)
- Company-paid life insurance
- Tuition reimbursement
- Minimum of 18 days of paid time off per year
- Paid holidays
- Leaves of absence
- Cable broadband or fiber optic internet service with at least 10Mbps download/5Mbps upload for home working