The Eligibility Senior Analyst is responsible for handling daily operational issue resolution, special projects and administrative operational support for the Client Service Team and Account Management Operations. Position requires account and operational knowledge in order to identify route cause, resolve issues, identify trends, and ensure client satisfaction.

Essential Functions

• Provide business support to clients and account management to ensure satisfaction with issue resolution.
• Consults with Account Management, leadership, and other ESI areas to provide analysis and direction on prioritizing and resolving client issues, with minimal client interaction.
• Responsible for handling daily routine issue analysis, work assignments, and other administrative support.
• May facilitate activities with other areas to oversee delivery of client’s needs.
• Participate in process improvement activates and share ideas for enhancing processes.
• With a focus on quality and timeliness, maintain ownership for assigned work queue.
• Meet all service standards to ensure client satisfaction.
• Handle routine work stream assignments along with, but not limited to, member and file research, assisting with file processing, advisory role to account mgmt.
• Resolve issues and provide escalation as needed.
• Participate in process improvement conversations and implementation.
• Provide support for year end and 1/1 readiness activities outside of normal schedule.
• Participate in team meetings as required.
• Maintain performance metrics as required.

Qualifications

• High School Diploma or equivalent required
• Strong analytical and problem-solving skills
• Excellent communication (oral and written) and presentation skills
• Demonstrated ability to adapt in a dynamic work environment and make decisions with minimal supervision
• Ability to manage timelines and deadlines
• Detail oriented, ability to multitask in a fast-paced environment
• Ability to work collaboratively with other departments to resolve issues with innovative solutions
• Proficiency using MS Office software

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.