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Eligibility Senior Representative - Remote


United States
Base Salary
37k-56k USD
The Cigna Group

Job Description

Cigna is currently hiring a Eligibility Senior Representative. The Eligibility Senior Representative in Client Operation by investigating/resolving eligibility request from both internal and clients. Delivers specific delegated Eligibility tasks assigned by a supervisor. Implements, updates, and maintains automated, direct connect and/or manual eligibility data. May handle National Accounts or more complex accounts. Reconciles accounts for non-standard requests. May provide technical support for the electronic procession of eligibility. Ensures customer data is installed accurately and timely. Analyzes formats that are customized directly by the client. May work directly with Systems to design formats. Provides recommendations to decrease errors. Thorough technical knowledge of manual and automated eligibility. Completes day-to-day Eligibility tasks without immediate supervision, but has ready access to advice from more experienced team members. Tasks involve a degree of forward planning and anticipation of needs/issues. Resolves non-routine issues escalated from more junior team members.


  • Research, analyze and process routine eligibility inquiries and DES for employers/brokers and internal partners.

  • Communicate outcome and next steps if applicable.

  • Service customers across in the Facets platform.

  • Interact with internal/external customers and business partners in a professional manner (includes verbal and written interactions).

  • Handle transactional tasks.

  • Manage resolution in a timely manner and provide status to all appropriate parties when resolved.

  • Navigate via multiple Cigna systems including Facets, client self-service portals and Onbase.

  • Upload and Complete eligibility via a macro process called DES and provide outcome of the upload which includes fallout, membership and any discrepancy or clarification requirement to ensure accuracy in eligibility submission to Facets.


  • High School Diploma or GED. Bachelor’s degree preferred.

  • 1+ year Facet Eligibility, Call or Claim experience required.

  • Ability to quickly understand the customer’s needs and expectations.

  • Demonstrated time management skills.

  • Detail oriented and ability to effectively problem-solve issues to resolution.

  • 2+ years experience with multiple software and system-based applications, including database and spreadsheets (Word, Excel, tracking systems).

  • Strong verbal/written communication and organizational skills to effectively communicate and interact with all levels and functions within the organization.

  • Ability to manage multiple and divergent priorities and deadlines, work independently and proactively, negotiate and manage expectations for mutually acceptable solutions.

  • MOS Background preferred.

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 18 - 27 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: [email protected] for support. Do not email [email protected] 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.

Advice from our career coach

A successful applicant for the Eligibility Senior Representative role at Cigna should be detail-oriented, possess strong communication skills, and have a background in Facet Eligibility, Call, or Claim experience. Here are some tips to stand out as an applicant:

  • Highlight any relevant experience with Facet Eligibility, Call, or Claim processes prominently on your resume.
  • Demonstrate your ability to quickly understand customer needs and expectations in your cover letter.
  • Showcase your time management skills and ability to problem solve effectively in previous roles during the interview.
  • Emphasize your experience with software applications, database management, and spreadsheets, including Word, Excel, and tracking systems.
  • Provide examples of how you have successfully managed multiple priorities and deadlines independently in your previous positions.
  • If possible, highlight any background in MOS, as it is preferred for this role at Cigna.

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About the job

Jul 10, 2024


37k-56k USD

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