Eligibility Representative - Payer Solutions (Finance)
GENERAL PURPOSE:
Incumbent will be a member of the Payer Solutions Operations eligibility team; the primary responsibility is eligibility maintenance.
RESPONSIBILITIES:
- Responsible for eligibility maintenance of Payer Solutions member data in Genasys
- Timely Payer notification of errors
- Clarifies member data as necessary
- Supports Payer with manual updates when applicable
- Works with matrix partners to correct data disjoints in downstream
- Responsible for membership reporting
- Supports eligibility inquiries from internal staff and clients (phone, email, meetings, Webex)
- Responsible for IF reversals, which includes validation that requests contain proper approval and tracking each reversal
- Responsible reporting production- weekly reports and monthly production reports
- Performance Guarantee tracking, as required.
- Understanding of data flow and process for correcting data disjoints
- Project SME
- Other duties as assigned
SKILLS/Knowledge
- 3-4 years of customer service and claim experience. Eligibility experience preferred.
- Strong written and verbal skills
- Genasys AS/400 experience preferred
- OneNote, HTM, ODS, IBoR/Impersonator experience preferred
- Demonstrated organizational, analytical and problem-solving ability
- Ability to prioritize work and manage multiple projects with competing deadlines
- Intermediate Skills in Word, Excel, Access and OneNote
- Ability to pass a keyboarding test which includes 10 Key skills
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 - 25 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 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 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 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.
