Eligibility Representative

Enrollment Representative Job Description

(Job Code: P01044)

Role Summary

The Enrollment Representative is responsible for processing requests from clients to set up or update customer information/manual eligibility data requests both manually and electronically. This involves both data entry and updating existing electronic eligibility and online enrollment (OLE) accounts. This position is critical role in providing high quality and accurate results as the data entry provides ID cards and benefit coverage to Cigna customers.

Responsibilities

• Process inbound client requests to enroll new membership, make edits to existing or process terminations to existing membership
• Process transactions on fallout reports using specific work instructions for each of the various reports
• Perform research to identify and resolve inconsistencies in eligibility data through individual analysis
• Assist in the client set up for electronic eligibility and online enrollment tools, following specific work instructions and guidelines provided by internal resources
• Assist with testing as needed; input enrollment in to test environment and process enrollment examples and provide input during testing on the outcome
• Additional responsibilities as assigned

Expectations

• Assess the inbound request/files and complete the data entry into Diamond following work instructions with accuracy and speed
• Conduct Iteam loads, MTRs, and BOTS to assist with OLE and Electronic eligibility needs
• Process MBA enrollments at point of VOB/GOP submission
• Assist with Middle East enrollment as identified
• Load and test enrollments per examples provided in test/UAT environment
• Communicate with all necessary internal and external business partners in a professional manner in a variety of communication styles (i.e. e-mail, telephone, Webex meetings, etc.)

Competencies:

• Action Oriented
• Customer Focus
• Cross-Cultural Sensitivity
• Drive for Results
• Learning on the Fly
• Organizing
• Priority Setting
• Problem Solving
• Time Management

Qualifications

• High School Diploma or GED required. Bachelor’s Degree preferred
• 2+ years’ experience in with US or International healthcare
• Strong Written and verbal communications skills
• Previous work experience in a fast-paced business environment
• High Attention to detail
• Demonstrated ability to consistently meet and exceed performance metrics such as productivity and quality
• Adept computer skills, with experience navigating multiple systems to complete a single task
• Intermediate to advanced skills using Microsoft Office products, specifically Excel and Outlook (V-Look up proficiency, pivot tables, formulas)
• Strong Analytical Skills and problem solving skills
• Ability to Learn Quickly

About The Cigna Group