Senior Eligibility Representative

The Cigna Group

. Perform specialized patient access and eligibility functions .

Posted 9/15/2026full-timeHonolulu • Hawaii • United StatesSenior💰 $19 - $29 per hourWebsite

Core Competencies

Role fit

Core Competencies

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

Demonstrates expertise in patient access and eligibility functions, with a strong focus on medical insurance knowledge and problem-solving skills. Proven ability to collaborate across departments and manage complex client interactions effectively.

Highest-signal resume keywords

Patient Access FunctionsMedical Insurance KnowledgeProblem-Solving SkillsMicrosoft Office SuiteData Entry Skills

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Medical Benefit VerificationPharmacy Benefit VerificationRevenue OptimizationPolicy Benefits ResearchReimbursement Coordination

Soft Skills

Attention to DetailCommunication SkillsCustomer Service SkillsAdaptabilityCollaboration

Tools & Technologies

Patient Management Tracking ToolsMicrosoft Office Suite

Industry Keywords

Health CareInsurance CriteriaDeductiblesCopaymentsClient Complaints

About the role

Key responsibilities & impact

Perform specialized patient access and eligibility functions
Liaise with payers, pharmaceutical companies, physicians, patients, and external clients
Facilitate cross-functional resolution of drug coverage issues
Research and resolve issues impacting revenue optimization
Perform complex medical and pharmacy benefit verification using internal patient management tracking tools
Contact benefit providers to gather policy benefits and limitations
Coordinate services to ensure reimbursement, including deductibles, copayments, effective dates, levels of care, and authorizations
Ensure shipments clear according to insurance criteria while minimizing bad-debt risk
Provide expert assistance to clients on patient status
Provide referral status reporting to external clients
Handle challenging customers and complex client complaints, escalating as appropriate
Complete other projects and duties as assigned
Handle incoming and outgoing calls comprising approximately 30% to 50% of the workday

Requirements

What you’ll need

High school diploma or GED required; bachelor’s degree preferred
2+ years of relevant working experience
Health care or professional office experience with medical insurance knowledge and terminology preferred
Advanced problem-solving skills
Ability to work collaboratively with other departments to resolve issues with innovative solutions
Proven attention to detail skills
Intermediate data entry skills
Working knowledge of Microsoft Office Suites
Excellent phone presentation and communication skills
Interest and curiosity to learn new skills in a changing environment
Ability to adapt in a dynamic work environment and make decisions with minimal supervision
Candidates must live on the island of Oahu
Ability to work in person in a hybrid role
Ability to work at the 677 Ala Moana Blvd, Suite 404, Honolulu, HI 96813 office two times per week
Home internet, if working remotely, must be cable broadband or fiber optic with at least 10Mbps download/5Mbps upload

Benefits

Comp & perks

Annual bonus plan eligibility
Medical, vision, and dental benefits starting on day one
Well-being and behavioral health programs
401(k)
Company-paid life insurance
Tuition reimbursement
Minimum of 18 days of paid time off per year
Paid holidays
Leaves of absence