Prior Authorization Representative- Evernorth- Remote

Job Summary

If you are organized, patient focused, and ready to grow in healthcare, this role is a great place to start. As a Prior Authorization Representative, you will help patients get approval for Enteral Nutrition services by working with insurance companies, care teams, and providers. You build strong communication skills, and support a team that is focused on timely, compassionate service.

Responsibilities

• Submit initial and renewal prior authorization requests through payer portals, phone, fax, or other approved methods.
• Track open requests and follow up on time to help reduce delays in care.
• Review information for accuracy and completeness before sending requests to insurance plans.
• Work with clinicians and internal teams to gather documents needed to support authorization requests.
• Share clear updates with patients, prescribers, and team members about approvals, denials, or next steps.
• Respond to email, chat, and other requests in a timely and professional way.
• Manage daily tasks and priorities while meeting team quality and productivity goals.
• Keep patient information private and document work accurately.

Qualifications

• High school diploma or GED.
• Minimum 1 year of experience in customer service, administrative support, healthcare support, insurance, call center, data entry, or a related role.
• Basic knowledge of medical terminology.
• Comfort using computers and Microsoft Office applications, including Outlook, Word, and Excel.
• Clear written and verbal communication skills.
• Strong attention to detail and ability to stay organized while managing multiple tasks.
• Customer-focused mindset and ability to work well with patients, providers, and internal teams.
• Ability to handle confidential patient information with care.

Preferred Qualifications

• Experience in healthcare, insurance verification, prior authorization, patient access, billing, pharmacy, home infusion, or durable medical equipment (DME).
• Familiarity with payer websites, insurance eligibility, coordination of benefits, formularies, denials, or appeals.
• Experience working in a fast-paced team environment where accuracy and follow-up are important.

About The Cigna Group

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.