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Eligibility Representative - Accredo - Remote image - Rise Careers
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Eligibility Representative - Accredo - Remote

The job profile for this position is Eligibility Representative, which is a Band 1 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.As an Eligibility Representative - Accredo, you’ll be part of a dedicated team which helps our specialty pharmacy patients coordinate their medication needs and pharmacy insurance coverage for complex medical conditions such as HIV, rheumatoid arthritis and cancer. This role is on the front lines with patients and doctors offices, responding to phone inquiries and addressing each with care, detail, and most importantly, empathy.Here’s a little more on how you’ll make a difference:• Help patients get the medication and services they need. Use the knowledge you gain from training, your problem-solving skills and support from your team to answer patient and provider calls effectively. You’ll coordinate and ensure services are covered under insurance coverage and talk to patients about their deductibles, co-payments, and authorizations.• Interact directly with healthcare providers. You’ll research issues on benefits coverage with pharmacist and doctors’ office and provide guidance to our patients about medication coverage.• Juggle multiple tasks without sacrificing attention to detail.  You will be busy handling multiple requests at any given time as well as documenting information from your conversations in our computer system.• What You Should Have:• High School Diploma / GED required, a bachelor’s degree is preferred.• Customer Service experience• Health care experience with knowledge of medical insurance and terminology is preferred and will make you successful in this role!• General PC knowledge including experience working with Microsoft Office• Excellent communication skills (verbal and written)What you’ll love about working here:• Fun, friendly, and unique culture – Bring your whole self to work every day!• Choice of three unique medical plans• Prescription Drug, Dental, Vision and Life Insurance• Employee Contributions for HRA and HSA accounts• 401K with Company Match• Paid Time Off and Paid Holidays• Tuition AssistanceIf 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.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.Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
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$18.02
$23.43

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What You Should Know About Eligibility Representative - Accredo - Remote, The Cigna Group

Are you ready to embark on a fulfilling career journey? As an Eligibility Representative at Accredo, you'll find yourself at the heart of helping specialty pharmacy patients navigate their medication needs and insurance coverage for complex medical conditions, including HIV, rheumatoid arthritis, and cancer. Within this remote role from Indiana, you'll be part of a dedicated team where your support and empathy make a real difference in people’s lives. Your day-to-day will involve responding to patient and healthcare provider inquiries with care and precision. Utilizing your training and problem-solving skills, you'll assist patients in understanding their insurance benefits, handling everything from coverage and deductibles to authorizations. You are the linchpin that connects patients with the services they require, ensuring they receive their medications promptly and efficiently. Plus, you’ll be engaging directly with healthcare providers, ensuring all details about medication coverage are addressed. Enjoy a culture that encourages personal growth and provides exciting benefits like competitive medical plans, 401K matching, paid time off, and even tuition assistance! If you have a high school diploma or GED, experience in customer service, or healthcare, and are eager to contribute your voice in helping patients, we would love to hear from you. Join us at Accredo, where you'll thrive in a fun and friendly environment that truly celebrates its people. Apply today and be a part of something special!

Frequently Asked Questions (FAQs) for Eligibility Representative - Accredo - Remote Role at The Cigna Group
What responsibilities can I expect as an Eligibility Representative at Accredo?

As an Eligibility Representative at Accredo, your main responsibilities will include addressing inquiries from both patients and healthcare providers regarding medication needs and insurance coverage. You'll help patients understand their insurance benefits, such as deductibles, co-payments, and authorizations, while also coordinating coverage with healthcare providers. Your problem-solving skills will be put to good use as you navigate multiple tasks, ensuring that all patient interactions are documented accurately.

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What are the qualifications needed for the Eligibility Representative position at Accredo?

To qualify for the Eligibility Representative role at Accredo, candidates must have at least a high school diploma or GED, with a bachelor’s degree preferred. Relevant customer service experience is essential, and familiarity with healthcare systems, medical terminology, and insurance processes will greatly enhance your success in this role. Strong communication skills, both verbal and written, are also crucial.

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Does Accredo offer remote work positions for Eligibility Representatives?

Yes, Accredo offers remote positions for Eligibility Representatives, allowing you to work from the comfort of your home in Indiana. However, it's important to ensure that you have a reliable internet connection meeting the required speeds for effective work performance.

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What benefits can I expect when working as an Eligibility Representative at Accredo?

Working as an Eligibility Representative at Accredo comes with a variety of attractive benefits, including a choice of three medical plans, prescription drug, dental, vision, and life insurance options. Additional perks include a 401K with company match, paid time off, paid holidays, and assistance with tuition, fostering a positive work-life balance.

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What kind of training will I receive for the Eligibility Representative role at Accredo?

Accredo provides comprehensive training for Eligibility Representatives, equipping you with the knowledge about insurance processes, medical terminology, and the tools required to excel in patient interactions. This training will empower you to confidently assist patients and healthcare providers, ensuring that you are prepared for the challenges of the role.

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Common Interview Questions for Eligibility Representative - Accredo - Remote
Can you describe your experience with customer service?

When answering questions about your customer service experience, focus on specific instances where you've successfully resolved issues or helped customers understand complex information. Use real examples that showcase your communication skills and problem-solving abilities—these traits are crucial for an Eligibility Representative at Accredo.

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How would you handle a challenging interaction with a patient?

In response to a question about handling challenging situations, emphasize your approach to active listening, empathy, and problem-solving. Provide an example from your experience where you managed a difficult situation calmly, showcasing your ability to find a resolution while maintaining a compassionate attitude.

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Why do you want to work for Accredo as an Eligibility Representative?

This question gives you the chance to convey your enthusiasm for the role and the company. Discuss Accredo’s mission, culture, and dedication to patient care, highlighting how these align with your own values and career aspirations. Be sure to express your enthusiasm for contributing positively to the team.

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What do you know about the healthcare industry?

When discussing your knowledge of the healthcare industry, highlight your understanding of medical insurance, terminology, and current trends affecting the specialty pharmacy sector. Mention any relevant experiences that have contributed to your understanding, as it will demonstrate your preparedness for the Eligibility Representative role.

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How do you prioritize tasks when handling multiple requests?

To answer this, explain your time management strategies and how you stay organized. You might mention tools you use, such as task lists or prioritization frameworks, and give an example of a time you successfully managed competing demands, showcasing your ability to maintain quality and attention to detail.

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Can you give an example of a time you went above and beyond for a customer?

Share a specific instance when you provided exceptional service, detailing what actions you took and the outcome. This demonstrates your commitment to customer satisfaction and your potential as an Eligibility Representative, reinforcing your dedication to patients' needs at Accredo.

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How do you stay updated with changes in healthcare regulations?

Discuss how you proactively seek information through reputable sources such as industry news, continuing education opportunities, or subscriptions to healthcare publications. This shows your commitment to staying informed and compliant, which is essential for an Eligibility Representative.

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What do you consider the most important quality for an Eligibility Representative?

You might highlight empathy as a core quality, explaining how connecting with patients on a human level can significantly impact their experience. Provide examples that illustrate how being empathetic can lead to more effective communication and problem resolution.

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How would you document a patient interaction effectively?

In your response, emphasize the importance of accurate documentation for clarity in patient care. Explain your approach—perhaps including details such as summarizing the conversation, noting key points, and ensuring it aligns with company policies, demonstrating your thoroughness as an Eligibility Representative at Accredo.

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What are your long-term career goals, and how does this role fit into them?

For this question, articulate your aspirations clearly, aligning them with the values and growth opportunities offered at Accredo. Discuss how the Eligibility Representative role provides a foundation for your career in healthcare, encouraging continuous development and enhancing your contributions to patient care.

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Cigna Healthcare is a world renowned, American multinational company dedicated to improving health and wellness. They are based in Bloomfield, Connecticut and offers Medicare and Medicaid products and health, life and accident insurance coverages.

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Full-time, remote
DATE POSTED
March 21, 2025

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