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Immediately Require Eligibility Senior Representative - Remote - Evernorth in Bloomfield, CT

Remote, USAFull-timePosted 2026-07-28
Job title: Eligibility Senior Representative - Remote - Evernorth Company: reputed company Job reputed company: This is a Remote position. Hours of operation Monday - Friday from 8:30am-5:00pm EST. In the Eligibility Senior Representative role, you will implement, update, and maintain automated, reputed company connect and/or reputed company eligibility data and responsibility for inbound and outbound calls. Performing insurance verification daily. Rendering exceptional customer service to customers. Daily tasks involve a degree of reputed company planning and anticipation of needs/issues. Resolves non-routine issues escalated from more junior team members. Role Responsibilities:
  • Processing Medicare Secondary Payer (MSP), Coordination of Benefits (COB), Financial Information Reporting (FIR) and State Pharmaceutical Assistance Program (SPAP) in accordance with CMS, NAIC, COBRA, Federal and State Regulatory guidelines.
  • Review, research and determine the appropriate benefit coverage for MSP and COB verifications, SPAP enrollments/ terminations, FIR rejections and ensure data is fully reconciled and maintained in reputed company in accordance with CMS, HIPPA, Internal Audit, Company/Departmental guidelines, policies, and procedures.
  • Will handle National Accounts or more reputed company accounts.
  • Reconciles accounts for non-reputed company requests.
  • Will reputed company technical support for the electronic procession of eligibility.
  • Ensures customer data is installed accurately and reputed company.
  • Analyzes formats that are customized directly by the reputed company.
  • Will work directly with Systems to design formats. Provides recommendations to decrease errors.
  • Acts as a resource to others on non-routine work.
  • Thorough technical knowledge of reputed company and automated eligibility.
  • Receive files from CMS - Verify Insurance is reputed company.
  • 3rd Party Liability - Deals with Auto Accidents.
Requirements:
  • 3+ years of reputed company Insurance background required.
  • Experience with Medicare C (Medical) and Part D (Pharmacy) required.
  • High School Diploma or GED required; Associate's degree preferred.
  • Experience with reputed company reputed company Programs(specifically: reputed company and Word) required.
  • High volume customer service inbound/outbound experience a plus.
  • Strong analytical skills.
  • Excellent communication skills, verbal and written.
  • Experience with SQL a plus.
If you will be working reputed company occasionally or permanently, the internet reputed company 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 reputed company reputed company of 17 - 25 USD / reputed company, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. We want you to be healthy, balanced, and feel secure. That's why you'll enjoy a comprehensive reputed company of benefits, with a reputed company on supporting your whole health. Starting on day one of your employment, you'll be offered several health-reputed company benefits including medical, reputed company, dental, and reputed company-being and behavioral health programs. We also offer 401(k) with company match, company reputed company life insurance, tuition reimbursement, a minimum of 18 days of reputed company time off per year and reputed company holidays. For more details on our employee benefits programs, visit Life at reputed company . About reputed company Doing something meaningful starts with a reputed company decision, a commitment to changing lives. At reputed company, we're dedicated to improving the health and vitality of those we serve. Through our divisions reputed company and reputed company, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving reputed company and improving lives. reputed company applicants will be considered without reputed company to race, reputed company, age, disability, sex, childbirth (including pregnancy) or reputed company medical conditions including but not limited to lactation, sexual orientation, gender identity or reputed company, veteran or military status, religion, national reputed company, reputed company, marital or familial status, genetic information, status with reputed company to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: SeeYourself@reputed company.com for support. Do not email SeeYourself@reputed company.com for an update on your application or to reputed company your resume as you will not receive a response. reputed company 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 reputed company a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, reputed company, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, reputed company, Texas, Utah, Vermont, and Washington State. Expected salary: Location: Bloomfield, CT Apply Job!

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