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Cigna Eligibility Representative Jobs (NOW HIRING)

Cigna

Claims Representative - Remote

$19/hr

Claims are processed according to benefits, eligibility, and internal processes, policies, and ... At The Cigna Group, you'll enjoy a comprehensive range of benefits, with a focus on supporting your ...

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Cigna

Dedicated Client Service Partner

Orlando, FL · On-site

$15 - $20.25/hr

As a Dedicated Client Service Partner , you will serve as an extension of the Cigna Account ... Resolve complex escalated issues involving claims, denials, authorizations, appeals, eligibility ...

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Cigna Eligibility Representative information

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How much do cigna eligibility representative jobs pay per hour?

As of Aug 27, 2026, the average hourly pay for cigna eligibility representative in the United States is $22.59, according to ZipRecruiter salary data. Most workers in this role earn between $18.03 and $25.72 per hour, depending on experience, location, and employer.

What does a Cigna Eligibility Representative do?

A Cigna Eligibility Representative is responsible for verifying and maintaining the eligibility status of customers for various Cigna health insurance plans. They review and process enrollment and eligibility information, respond to customer and provider inquiries, and ensure that all data is accurate and up to date. Their work helps ensure that members receive the correct benefits and services, and they often collaborate with other departments to resolve complex eligibility issues.

What are the key skills and qualifications needed to thrive as a Cigna Eligibility Representative?

To thrive as a Cigna Eligibility Representative, you need a strong understanding of healthcare insurance processes, attention to detail, and typically a high school diploma or equivalent. Familiarity with claims processing systems, eligibility databases, and Microsoft Office Suite is often required. Outstanding customer service, problem-solving abilities, and effective communication skills help you resolve inquiries and support clients. These skills ensure accurate eligibility determination, efficient issue resolution, and a positive customer experience.

What are some common challenges Cigna Eligibility Representatives face, and how can they effectively manage them?

Cigna Eligibility Representatives often encounter challenges like handling high volumes of inquiries and resolving complex eligibility issues for members and providers. To manage these effectively, strong attention to detail and excellent communication skills are essential, as is the ability to navigate multiple systems simultaneously. Representatives can benefit from staying updated on policy changes and working closely with team members and other departments to resolve escalated cases efficiently. Regular training and leveraging available resources help ensure accuracy and maintain service quality.

What is the difference between Cigna Eligibility Representative vs Cigna Customer Service Representative?

AspectCigna Eligibility RepresentativeCigna Customer Service Representative
Primary RoleVerify and determine patient insurance eligibility and benefitsAssist customers with inquiries, claims, and account issues
Required CredentialsHigh school diploma; some roles may prefer insurance or healthcare certificationsHigh school diploma; customer service experience beneficial
Work EnvironmentOffice setting, healthcare or insurance companyOffice or call center environment, healthcare or insurance company
Industry UsageCommonly used in health insurance companies like CignaWidely used across insurance and healthcare providers

The Cigna Eligibility Representative focuses on verifying patient insurance coverage and benefits, ensuring accurate eligibility information. In contrast, the Cigna Customer Service Representative handles a broader range of customer inquiries, including claims and account issues. Both roles require similar credentials and work in comparable environments within the healthcare insurance industry, but their primary responsibilities differ.

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The most popular types of Cigna Eligibility Representative jobs are:

What states have the most Cigna Eligibility Representative jobs?

States with the most job openings for Cigna Eligibility Representative jobs include:

What job categories do people searching Cigna Eligibility Representative jobs look for?

The top searched job categories for Cigna Eligibility Representative jobs are:

Cigna Eligibility Representative jobs near you
Infographic showing various Cigna Eligibility Representative job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 79% Full Time, 18% Part Time, and 2% Contract. Highlights an 96% Physical, 1% Hybrid, and 3% Remote job distribution, with an average salary of $46,986 per year, or $22.6 per hour.

Eligibility Representative - Accredo - Remote

Remote

Cigna
Health Care and Social Assistance • 10K+ employees

8.3

Company rating: 8.3 out of 10

Based on 240 frontline employees who took The Breakroom Quiz

40th of 893 rated healthcare providers

People enjoy working here

Good employer

Recommended by students

Learn more about Cignaexternal

Full-time

Medical

Posted 12 days ago

Job description

As an Eligibility Representative, you'll be part of a dedicatedteam whichhelps our specialty pharmacy patients coordinate their medication needs and pharmacy insurance coverage for complex medical conditions. This role handles each inquiry with care, detail, and most importantly, empathy.

Here's a little more on how you'll make a difference:

PRIMARY RESPONSIBILITIES:

  • Review and interpret insurance eligibility, coverage details, and benefit limitations to determine clearance requirements.

  • Initiate outbound communication with insurance plans and thirdparty payers to obtain benefit details, resolve coverage questions, and confirm authorization requirements.

  • Navigate prior authorization processes by gathering required information and ensuring payer criteria are met accurately.

  • Document benefit findings, authorization outcomes, and clearance decisions thoroughly and consistently within internal systems.

  • Apply feedback and payer knowledge to continuously improve accuracy, efficiency, and overall clearance quality.

QUALIFICATIONS:

  • Minimum of 1 year of experience in a healthcare or health insurance setting performing eligibility verification, benefits investigation, prior authorizations, or patient access support.

  • Direct experience working with insurance plans or payers, including outbound calls to obtain or clarify coverage information.

  • Working knowledge of pharmacy (PBM) benefits and medical benefits, with the ability to interpret plan details accurately.

  • Experience documenting insurance and authorization information with a high level of accuracy and attention to detail.

  • Ability to manage detailed, repetitive work in a structured environment while maintaining consistency and quality.

  • Strong written and verbal communication skills appropriate for professional interactions with payer representatives.

  • High School Diploma or equivalent.

  • Must live and work remotely in one the following states: Alabama, Indiana, South Carolina, or Tennessee.


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.

About Evernorth Health Services

Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. 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 need a reasonable accommodation to complete the online application process, please email seeyourself@thecignagroup.com for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.

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.

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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About Cigna

Sourced by ZipRecruiter

Cigna Corporation exists to improve lives. We are a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. Together, with colleagues around the world, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation. When you work with us, or one of our subsidiaries, you'll enjoy meaningful career experiences that enrich people's lives.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Bloomfield, CT, US

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