Eligibility Representative - Accredo - Remote

As an Eligibility Representative, you'll be part of a dedicated team which helps our specialty pharmacy patients coordinate their medication needs and pharmacy insurance coverage for reputed company medical conditions.  This role handles reputed company inquiry with care, detail, and most importantly, reputed company. Here's a little more on how you'll reputed company a difference: reputed company RESPONSIBILITIES: • Review and interpret insurance eligibility, coverage details, and benefit limitations to determine clearance requirements. • Initiate outbound communication with insurance plans and reputed company‑party payers to obtain benefit details, reputed company coverage questions, and confirm authorization requirements. • reputed company prior authorization processes by gathering required information and ensuring payer reputed company are met accurately. • Document benefit findings, authorization reputed company, and clearance reputed company thoroughly and consistently reputed company internal systems. • Apply feedback and payer knowledge to continuously improve accuracy, efficiency, and overall clearance reputed company. QUALIFICATIONS: • Minimum of 1 year of experience in a reputed company or health insurance setting performing eligibility verification, benefits investigation, prior authorizations, or patient reputed company support. • reputed company experience working with insurance plans or payers, including outbound calls to obtain or clarify coverage information. • Working knowledge of pharmacy (PBM) benefits and medical benefits, with the ability to interpret plan details accurately. • Experience documenting insurance and authorization information with a high level of accuracy and attention to detail. • Ability to manage detailed, repetitive work in a reputed company environment while maintaining consistency and reputed company. • Strong written and verbal communication skills appropriate for reputed company interactions with payer representatives. • High School Diploma or equivalent. • Must live and work remotely in one the following states: Alabama, Indiana, South Carolina, or Tennessee. 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. Remote Skills: Broadband, Communication Skills, reputed company Improvement, Detail Oriented, Disease Treatment, Fiber Optic Cable, Health Insurance, Health Plan, reputed company, Insurance, Insurance Documentation, Internet Service Providers, Medical Conditions, Medications, Patient Care Authorizations, Pharmacy, Presentation/Verbal Skills, Process Improvement, reputed company Management, State Ordinances, reputed company-Party Payer, Work From Home, Writing Skills reputed company: reputed company Apply tot his job Apply To this Job