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Eligibility Senior Representative

4 months ago

Remote, Oregon, United States The Cigna Group Full time
The job profile for this position is Eligibility Senior Representative, which is a Band 2 Professional Career Track Role.

Excited to grow your career?

We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply

Our people make all the difference in our success.

Do you want to improve the health and vitality of those we serve? The Cigna Group is hiring an Eligibility Senior Representative. You'll determine Medicare plan enrollment eligibility. You'll review Medicare, Medicaid or Medicare Advantage plan enrollment applications, and research various CMS websites to determine enrollee eligibility based on CMS, chapter 2 election period requirements.

How you'll make a difference:

  • Responsible for determining / validating Medicare plan eligibility via various federal and state CMS websites
  • Research and respond to plan enrollment eligibility inquiries as needed
  • Ensure all Medicare, Medicaid and Medicare Advantage plan enrollment eligibility is reconciled and maintained in accordance with CMS and departmental guidelines, requirements, regulations, policies, and procedures
  • Review incoming enrollment plan applications, keying information into systems, determining eligibility, and properly saving submissions as needed
  • You may also work with the sales agents to obtain additional information as needed on enrollees

What you'll need to succeed:

  • High school diploma or GED required
  • 1+ years of experience with Medicare plan enrollment eligibility, (chapter 2 election period requirements) with Medicare and state Medicaid, highly preferred
  • 1+ years of experience with plan enrollment eligibility requirements Medicare Advantage - Part C, highly preferred
  • Prior data entry and Medicare plan enrollment experience, highly preferred
  • 1+ years of experience with prior Medicare, Medicaid or Medicare Advantage plan enrollment eligibility and/or reconciliation strongly preferred
  • Proficient with Microsoft Office suite products, (Excel, Outlook, Word,) required
  • Critical thinking and strong attention to detail, required
  • Excellent verbal and written communication skills - communications should be respectful, professional, proactive and polite at all times, required
  • Must be able to act quickly and proactively in a rapidly changing and dynamic work environment, required
  • Strong Customer Service skills, required
  • Strong organizational skills and ability to manage multiple tasks simultaneously in a fast-paced, customer-oriented environment, required

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 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.

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.

Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link.