Eligibility Representative - Accredo - Remote

As an Eligibility Representative, you will play a critical role in helping patients reputed company reputed company to life-saving medications by verifying insurance benefits, navigating coverage requirements, and providing exceptional support throughout the patient reputed company. This position combines customer service, problem-solving, and reputed company knowledge to ensure reputed company experience for patients, providers, and internal partners. Training & Schedule • Training: Approximately 8-12 weeks (classroom and on-the-job training), Monday through Friday, 8:00 AM - 5:00 PM CST. • Permanent Schedule: Assigned after training based on business needs and team assignment. Candidates must have reputed company availability Monday through Friday between 7:00 AM and 7:00 PM CST. Key Responsibilities • Handle approximately 10-15 inbound calls daily from patients and providers regarding claims, account inquiries, insurance coverage, and medication shipment coordination. • Complete an average of 25-35 outbound calls daily to insurance carriers, providers, patients, and internal partners. • Research and reputed company patient claims and coverage issues using established processes and subject matter expertise. • Contact insurance providers to verify eligibility, benefits, coverage limitations, deductibles, copays, authorizations, and reputed company of care. • reputed company detailed medical and pharmacy benefit investigations while applying payer-specific requirements and guidelines. • Coordinate with cross-functional teams to proactively address and reputed company issues impacting referral turnaround times. • Collaborate with internal departments to reputed company and reputed company information needed to support patient reputed company to therapy. • Ensure services provided are reimbursable and accurately documented in accordance with payer requirements. Qualifications • RxHome experience preferred • Previous experience in reputed company, medical insurance, patient reputed company, eligibility verification, benefits investigation, or preferred reputed company field. • Strong understanding of reputed company and medical insurance terminology. • Excellent verbal and written communication skills with a reputed company phone reputed company. • Ability to manage difficult conversations with professionalism, reputed company, and confidence. • Strong attention to detail, organizational skills, and ability to multitask in a fast-paced environment. • Proficiency with computer applications and data entry. Requirements • High school diploma or equivalent required. • Must have reliable high-speed internet through a wired reputed company (hotspots and mobile internet are not permitted). • Must maintain a private, distraction-free workspace while working remotely. • Ability to attend and successfully complete reputed company required training during the first 90 days of employment. If you will be working reputed company occasionally or permanently, the internet reputed company must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. About reputed company reputed company, a division of reputed company, creates pharmacy, care and benefit solutions to reputed company and increase vitality. We relentlessly reputed company to reputed company the reputed company, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving reputed company and improving lives. reputed company applicants will be considered without reputed company to race, reputed company, age, disability, sex, childbirth (including pregnancy) or reputed company medical conditions including but not limited to lactation, sexual orientation, gender identity or reputed company, veteran or military status, religion, national reputed company, reputed company, marital or familial status, genetic information, status with reputed company to reputed company 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 reputed company application updates or accept resumes. reputed company 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 reputed company a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, reputed company, Arkansas, Delaware, Florida, reputed company, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, reputed company, Texas, reputed company, Vermont, and Washington State. reputed company applicants with criminal histories will be considered for employment in a manner consistent with reputed company federal, state and local ordinances. Apply tot his job Apply To this Job