Prior Authorization Representative

The Cigna Group

. Submit initial and renewal prior authorization requests through payer portals, phone, fax, or other approved methods .

Posted 11/12/2026full-timeRemote • United StatesJunior💰 $18 - $26 per hourWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in prior authorization processes, including submission and follow-up, while maintaining patient confidentiality and accuracy in documentation. Strong communication and organizational skills are essential for effective collaboration with patients, providers, and internal teams.

Highest-signal resume keywords

Prior Authorization ExperienceMedical Terminology KnowledgeMicrosoft Office ProficiencyCustomer Service SkillsAttention To Detail

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Prior AuthorizationInsurance VerificationData EntryMedical TerminologyBillingPharmacy KnowledgeHome InfusionDurable Medical Equipment (DME)Payer Websites FamiliarityCoordination Of Benefits

Soft Skills

Clear CommunicationOrganizational SkillsCustomer-Focused MindsetAbility To Handle Confidential InformationTeam Collaboration

Tools & Technologies

Microsoft OutlookMicrosoft WordMicrosoft ExcelPayer Portals

Certifications & Qualifications

High School DiplomaGED

Industry Keywords

Healthcare SupportInsurancePatient AccessSpecialty PharmacyInfusion Services

About the role

Key responsibilities & impact

Submit initial and renewal prior authorization requests through payer portals, phone, fax, or other approved methods
Track open requests and follow up on time to help reduce delays in care
Review information for accuracy and completeness before sending requests to insurance plans
Work with clinicians and internal teams to gather documents needed to support authorization requests
Share clear updates with patients, prescribers, and team members about approvals, denials, or next steps
Respond to email, chat, and other requests in a timely and professional way
Manage daily tasks and priorities while meeting team quality and productivity goals
Keep patient information private and document work accurately
Support CarepathRx within Evernorth Health Services’ Pharmacy and Care Delivery organization, focused on specialty pharmacy and infusion services

Requirements

What you’ll need

High school diploma or GED
Minimum 1 year of experience in customer service, administrative support, healthcare support, insurance, call center, data entry, or a related role
Basic knowledge of medical terminology
Comfort using computers and Microsoft Office applications, including Outlook, Word, and Excel
Clear written and verbal communication skills
Strong attention to detail and ability to stay organized while managing multiple tasks
Customer-focused mindset and ability to work well with patients, providers, and internal teams
Ability to handle confidential patient information with care
Preferred: Experience in healthcare, insurance verification, prior authorization, patient access, billing, pharmacy, home infusion, or durable medical equipment (DME)
Preferred: Familiarity with payer websites, insurance eligibility, coordination of benefits, formularies, denials, or appeals
Preferred: Experience working in a fast-paced team environment where accuracy and follow-up are important
For work at home, cable broadband or fiber optic internet service with at least 10Mbps download/5Mbps upload

Benefits

Comp & perks

Annual bonus plan eligibility
Medical, vision, and dental benefits
Well-being and behavioral health programs
401(k)
Company-paid life insurance
Tuition reimbursement
Minimum 18 days of paid time off per year
Paid holidays
Leaves of absence
Reasonable accommodation support for the application process