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Cigna Eligibility Representative Jobs (NOW HIRING)

Cigna

Claims Representative - Remote

New York, NY · 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 Eligibility Representative information

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$32

How much do cigna eligibility representative jobs pay per hour?

As of Jul 14, 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 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.

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, and why are they important?

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.
More about Cigna Eligibility Representative jobs
What are the most commonly searched types of Cigna Eligibility Representative jobs? 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 July 2026, with employment types broken down into 2% Locum Tenens, 45% Full Time, 3% Part Time, 38% Contract, 11% Nights, and 1% Summer. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $46,986 per year, or $22.6 per hour.
Claims Representative - Remote

Claims Representative - Remote

Cigna

New York, NY • Remote

$19/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 15 days ago

Cigna Healthcare rating

8.3

Company rating: 8.3 out of 10

Based on 235 frontline employees who took The Breakroom Quiz

39th of 884 rated healthcare providers

Job description

Claims Representative - Remote

SUMMARY

The claims representative is responsible for manually reviewing and processing medical, supplemental, or dental claims. Claims are processed according to benefits, eligibility, and internal processes, policies, and procedures and may be completed, held for additional information/review, or denied. New claim representatives will be provided with a robust training program, which includes virtual classroom training, on-the-job learning/feedback, and gradually increasing claims per hour/quality requirements over several months. After completion of training, claim representatives must meet specific accuracy/quality, volume/claims per hour, and on production performance metrics.

$19/Hour Pay Rate

RESPONSIBILITIES

Independently research and navigate various documents and databases to accurately process claims, ensuring compliance and adherence to established guidelines.

Confirm the presence of necessary documents within submitted claims.

Validate the accuracy of medical codes provided in claim submissions.

Assess the eligibility status of claims based on established criteria.

Review and verify other insurance coverage information in submitted claim.

Evaluate authorizations provided in claim submissions for accuracy.

Analyze account benefit plans to ensure claims align with coverage and policies.

Identify discrepancies, errors, or missing information.

Utilize multiple computer applications simultaneously.

Maintain self-discipline, consistently uphold a strong work ethic, and complete work tasks/responsibilities while working without close supervision.

Meet or exceed quality and productivity goals.

Identify claim processing learning opportunities by working directly with supervisors, coaches, and trainers to learn efficient and effective processing techniques and workflows.

Utilize a variety of virtual tools, including Outlook email, Cisco Webex, and similar applications, to effectively collaborate, communicate, and stay connected with colleagues and supervisors.

QUALIFICATIONS

High school diploma or equivalent

Ability to quickly learn a variety of computer applications to complete job functions,

Experience sending/receiving emails, scheduling calendar appointments/sending invitations, attaching files in Microsoft Outlook.

Knowledge of basic Microsoft Excel functions, such as filtering/sorting.

Experience in navigating multiple computer applications through the use of shortcut keys and other techniques.

Detail-oriented with experience in applying complex policy/procedure documents.

Strong organizational skills to maximize available work time. Ability to prioritize tasks to ensure job tasks are completed before deadlines.

Proven experience completing work with quality and productivity performance standards.

Experience working independently in a virtual environment preferred.

Experience with medical and insurance terminology in a professional setting preferred.

Knowledge of CPT/ICD-10 codes preferred.

Proven experience in health insurance claims processing or similar field preferred


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 17.75 - 26 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.


At The Cigna Group, 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), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year, paid holidays, and leaves of absence. For more details on our employee benefits programs, click here.


About The Cigna Group

Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we're dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. 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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