Experienced Eligibility Associate Representative – Healthcare Enrollment and Reconciliation Specialist for Medicare Part A & B, with Strong Technical and Analytical Skills

Introduction to The Cigna Group and Our Mission

The Cigna Group, a global health service company, is dedicated to improving the health, well-being, and peace of mind of those we serve. Through our commitment to excellence and our passion for making a difference, we strive to deliver innovative solutions that meet the evolving needs of our customers. As part of our team, you will have the opportunity to contribute to our mission and make a meaningful impact on the lives of others.

Role Overview: Eligibility Associate Representative

We are seeking an experienced and skilled Eligibility Associate Representative to join our team in a temporary contract opportunity through Magnit, an enterprise third-party vendor for contingent work. As an Eligibility Associate Representative, you will play a critical role in delivering specific delegated eligibility tasks, implementing updates, and maintaining automated and manual eligibility data. Your expertise will be essential in ensuring customer data is installed accurately and timely, and you will have the opportunity to work on a variety of projects, including reconciliation, technical support, and account benefit verification.

Key Responsibilities:

• Deliver specific delegated eligibility tasks assigned by a supervisor, including implementing, updating, and maintaining automated and manual eligibility data.
• Handle reconciliation for non-standard requests and provide technical support for the electronic processing of eligibility.
• Ensure customer data is installed accurately and timely, utilizing technical knowledge of manual and automated eligibility.
• Complete day-to-day eligibility tasks without immediate supervision, while having ready access to advice from more experienced team members.
• Facilitate accurate processing of enrollment applications to ensure timely input and acceptance to CMS.
• Perform account benefit verification requiring complex decision skills based on payer and process knowledge, resulting in proper access to care.
• Process reconciliation files from CMS, including disenrollments, late enrollment penalties, and low-income subsidies.
• Process coordination of benefits and Medicare secondary payer files from CMS to meet federal and state regulatory guidelines.
• Ensure accuracy of data entry to allow for meeting proper service level agreements.
• Use discretion and independent judgment in handling more complex cases and be willing to learn new skills within the enrollment functions.
• Directly interface with other teams within Cigna and provide support to other internal functions as needed.

Essential Qualifications:

• 3+ years of healthcare experience, required.
• 3+ years of experience with Medicare Part A & B, required.
• Technical and computer skills, including basic to intermediate level Excel, required.
• Analytical skills, customer service skills, and ability to learn quickly, required.
• Knowledge of CMS enrollment and reconciliation process, CMS billing requirements and regulations, and coordination of benefits and Medicare secondary payer, required.
• High school diploma or GED required, bachelor's degree preferred.
• 3+ years of relevant working experience, required.

Preferred Qualifications:

• Intermediate data entry skills and working knowledge of Microsoft Office, preferred.
• Excellent presentation and communication skills, preferred.
• Demonstrated ability to handle challenging interactions in a professional manner, preferred.
• Ability to adapt in a dynamic work environment and make decisions with minimal supervision, preferred.
• Advanced problem-solving skills and the ability to work collaboratively with other departments to resolve issues with innovative solutions, preferred.
• SQL skills, a plus.

Career Growth Opportunities and Learning Benefits

At The Cigna Group, we are committed to the growth and development of our employees. As an Eligibility Associate Representative, you will have access to a variety of training and development opportunities, including on-the-job training, mentorship programs, and online courses. You will also have the opportunity to work on a variety of projects, which will help you develop new skills and expand your knowledge of the healthcare industry.

Work Environment and Company Culture

The Cigna Group is a dynamic and fast-paced work environment that values innovation, teamwork, and customer satisfaction. As a remote employee, you will be part of a virtual team that is dedicated to delivering exceptional results and making a positive impact on the lives of our customers. Our company culture is built on a foundation of respect, integrity, and accountability, and we strive to create a work environment that is inclusive, supportive, and rewarding.

Compensation, Perks, and Benefits

The pay range for this position is $18.00 - $18.00 per hour, depending on experience. In addition to a competitive salary, we offer a range of benefits, including medical, dental, vision, and 401K (provided minimum eligibility hours are met). We also offer a variety of perks, including flexible scheduling, remote work options, and opportunities for professional development and growth.

Conclusion

If you are a motivated and experienced healthcare professional who is looking for a new challenge, we encourage you to apply for this exciting opportunity. As an Eligibility Associate Representative, you will have the opportunity to make a meaningful impact on the lives of our customers, while also developing new skills and advancing your career. Don't miss out on this opportunity to join our team and contribute to our mission of improving the health, well-being, and peace of mind of those we serve. Apply now and take the first step towards a rewarding new role!

How to Apply

To apply for this position, please submit your application through our website. We look forward to receiving your application and learning more about your qualifications and experience.