Eligibility Senior Representative - Accredo - Remote

Help patients and prescriber offices move through the access process with confidence. As an Eligibility Senior Representative on the phone queue, you will support specialty pharmacy services by answering inbound questions, explaining coverage and financial responsibility, and helping resolve issues that may delay therapy. This role is a great fit for someone who communicates clearly, solves problems with care, and wants to make a meaningful impact for patients.

Responsibilities

• 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 to help move referrals forward accurately and efficiently.

• Explain insurance benefits, copays, coinsurance, deductibles, and other financial responsibilities in a clear and professional way.

• Help patients understand available copay assistance, manufacturer assistance, and other financial support options.

• Identify barriers that may delay therapy, including insurance, authorization, financial, or coverage concerns, and help coordinate next steps toward resolution.

• Provide accurate updates on referral status, access requirements, and actions needed to support timely patient care.

• Manage escalated patient or prescriber concerns with professionalism, empathy, and sound judgment.

• Meet quality, productivity, and phone queue expectations while creating a positive caller experience.

Requirements

• High school diploma or equivalent.

*Must be able to work a Monday through Friday schedule between the hours of 9:00AM - 6:30PM EST

• Minimum of 1 year of experience in a phone queue, call center, healthcare, specialty pharmacy, patient access, reimbursement, insurance verification, customer service, or a related field.

• 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 where patient needs and business priorities may shift throughout the day.

Preferred Qualifications

• Experience conducting medical or pharmacy benefit investigations.

• Experience in specialty pharmacy, patient access, reimbursement support, or benefit investigation services.

• Knowledge of specialty drug reimbursement, copay assistance programs, and patient access support services.

• Experience working in a call center or phone queue environment.

• Experience discussing insurance benefits, copays, coinsurance, deductibles, and financial assistance options with patients.

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 - 29 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.

At The Cigna Group, 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), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year, paid holidays, and leaves of absence. For more details on our employee benefits programs, click here.

About Evernorth Health Services

Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. 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 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 provide application updates or accept resumes.

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.