About the Role

• As an Eligibility Representative, you will play a critical role in ensuring members have timely access to the healthcare benefits and services they need. Acting as a key point of contact for clients, customers, and internal stakeholders, you will manage eligibility administration, maintain accurate member records, and provide outstanding service through phone and email interactions.
• This role combines customer service, relationship management, data administration, and problem-solving in a fast-paced international environment. You will work closely with colleagues across multiple functions to deliver a seamless member experience while ensuring data accuracy and operational excellence.
• At Cigna Healthcare, you'll join a diverse and collaborative team where your contributions directly impact members' healthcare journeys every day.

What Does a Typical Day Look Like?

• Administer and maintain member eligibility information accurately and efficiently across multiple systems.
• Process new enrollments, membership updates, terminations, and benefit changes in line with service-level agreements.
• Update and maintain eligibility data through automated, direct-connect, and manual processes.
• Serve as a primary point of contact for clients, customers, vendors, and internal stakeholders regarding eligibility-related inquiries.
• Investigate and resolve discrepancies, data errors, and system issues impacting member records.
• Generate, analyze, and validate reports to ensure data integrity and operational accuracy.
• Provide technical support and guidance related to eligibility administration processes.
• Collaborate with clients and internal teams to resolve complex eligibility issues while maintaining strong professional relationships.
• Ensure customer and membership data is processed accurately, confidentially, and within required timelines.
• Identify opportunities for process improvement and contribute ideas that enhance efficiency, service quality, and customer satisfaction.
• Support business initiatives, projects, and continuous improvement activities within the Eligibility team.
• Maintain compliance with data privacy, confidentiality, and regulatory requirements at all times.

What We're Looking For

• Diploma, Bachelor's degree, or equivalent professional experience.
• Excellent written and verbal communication skills in English and French.
• Strong customer service orientation with a passion for delivering exceptional customer experiences.
• High level of accuracy and attention to detail.
• Ability to manage multiple priorities while meeting deadlines in a fast-paced environment.
• Strong problem-solving and analytical skills.
• Proficiency in Microsoft Office applications, particularly Excel and Outlook.
• Ability to quickly learn new systems, technologies, and processes.

Preferred Skills & Experience

• Experience working in customer service, healthcare administration, insurance operations, eligibility management, or a related field.
• Experience working with customer databases, reporting tools, and case management systems.
• Strong technical aptitude and ability to troubleshoot data and system-related issues.
• Ability to build and maintain positive relationships with internal and external stakeholders.
• Excellent organizational and time-management skills.
• Commitment to continuous improvement and operational excellence.

You Will Thrive in This Role If You...

• Enjoy interacting with customers and delivering excellent service.
• Are passionate about helping others and finding solutions to complex issues.
• Take ownership of your work and pay close attention to detail.
• Enjoy working with data, systems, and processes.
• Communicate confidently in both English and French.
• Are proactive in identifying improvements and driving positive change.
• Handle confidential and sensitive information with professionalism and integrity.
• Enjoy collaborating with colleagues across different teams, cultures, and countries.
• Adapt quickly to changing priorities and dynamic business needs.