Top 27 Eligibility worker Jobs in South Carolina

Eligibility Representative - Accredo - Remote
The Cigna Group —South Carolina
- Online Application
- Remote
- High school diploma or GED
- Fair chance
- 1 year
2d
ES Eligibility Specialist / 61012458
State of South Carolina —Edgefield County, SC
- $35,292 - $39,900 a year
- Monday to Friday
- Office
- Administrative experience
- High school diploma or GED
- Paid parental leave
- Paid holidays
4d
ES Eligibility Specialist (CNTY) / 61012802
State of South Carolina —Horry County, SC
- $35,292 - $39,900 a year
- Monday to Friday
- Office
- High school diploma or GED
- Driver's License
- Paid parental leave
- Paid holidays
3d
ES Eligibility Case Manager / 61013345
State of South Carolina —Greenwood County, SC
- $38,841 - $43,900 a year
- Monday to Friday
- Mid-level
- Office
- Residential
- Paid parental leave
- Paid holidays
3d
Eligibility Coordinator I / 60017004
State of South Carolina —Orangeburg County, SC
- $43,620 a year
- Overtime
- Mid-level
- Office
- High school diploma or GED
- Paid holidays
- Disability insurance
3d
REPOST ES Eligibility Case Manager (CNTY) / 61012955
State of South Carolina —Fairfield County, SC
- $38,841 - $43,900 a year
- Monday to Friday
- Customer service
- Research
- Mid-level
- Paid parental leave
- Paid holidays
Eligibility Specialist - PRN, As Needed
McLeod Health —South Carolina
- Part-time
- Hospital
- HIPAA
- Mid-level
Quick Apply
REPOST CERCU Eligibility Specialist / 61013661
State of South Carolina —Richland County, SC
- $39,192 a year
- Monday to Friday
- 5 years
- Research
- Mid-level
- Paid parental leave
- Paid holidays
ES Eligibility Specialist (CNTY) / 61012096 & 61012180
State of South Carolina —Bamberg County, SC
- $35,292 - $39,900 a year
- Monday to Friday
- Mid-level
- Office
- High school diploma or GED
- Paid parental leave
- Paid holidays
3h
Housekeeper
Spark by Hilton Orangeburg —Orangeburg, SC
- Weekends as needed
- Ability to walk for extended periods
- Hotel
- Ability to lift 50 pounds
- Paid holidays
- Health insurance
Quick Apply
6d
Front Desk Agent
Spark by Hilton Orangeburg —Orangeburg, SC
- Weekends as needed
- Microsoft Excel
- Writing skills
- Hotel
- Paid holidays
- Employee discount
Quick Apply
Eligibility Representative II
DECO Recovery Management —Greenville, SC
- Spanish
- Hospital
- Mid-level
Quick Apply
ES Eligibility Case Manager (CNTY) / 61013211
State of South Carolina —Greenville County, SC
- $38,841 - $43,900 a year
- Monday to Friday
- Mid-level
- Residential
- High school diploma or GED
- Paid parental leave
- Paid holidays
2d
Eligibility Coordinator II / 60017888
State of South Carolina —Richland County, SC
- $47,588 a year
- Overtime
- Mid-level
- Office
- Driver's License
- Paid holidays
- Disability insurance
3h
Internal Only: Eligibility Coordinator II / 60015297
State of South Carolina —Spartanburg County, SC
- $47,588 a year
- Overtime
- Mid-level
- Office
- Driver's License
- Paid holidays
- Disability insurance
4d
Math Teacher
ALA Blythewood —Blythewood, SC
- $53,000 a year
- Online Application
- Background check
- Classroom
- Teaching Certification
- Health insurance
- 401(k)
Quick Apply
Riddles Escape Room(Looking for ) stop ny in person anytime, We are open every day!!!
Captive Escape Rooms —Myrtle Beach, SC
- $14 - $16 an hour
- Temporary
- In person
- Customer service
- Public speaking
- Experience working with children
- Employee discount
- Flexible schedule
Quick Apply
SFP Facilitator
YOUNG MENS CHRISTIAN ASSOCIATION —Lexington, SC
- $15 - $16 an hour
- Part-time
- Ability to lift 50 pounds
- 21 years or older
- Children
6d
Front Desk Agent
Spark by Hilton Hilton Head Island —Hilton Head Island, SC
- Part-time
- Microsoft Excel
- Writing skills
- Hotel
- Paid holidays
- Employee discount
Quick Apply
Front Desk Agent
Holiday Inn Express Charleston Downtown - Medical Area —Charleston, SC
- Weekends as needed
- Microsoft Excel
- Writing skills
- Hotel
- Paid holidays
- Health insurance
Quick Apply

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Eligibility Representative - Accredo - Remote

The Cigna Group -
South Carolina

Apply Now

Job Details

Full-time
2 days ago

Benefits

Smoking cessation program

Qualifications

Medical insurance coverage verification
Health insurance customer support
Customer inquiry handling
Outbound calling

Full Job Description

As an Eligibility Representative, you’ll be part of a dedicated team which helps our specialty pharmacy patients coordinate their medication needs and pharmacy insurance coverage for complex medical conditions. This role handles each inquiry with care, detail, and most importantly, empathy.

Here’s a little more on how you’ll make a difference:

PRIMARY RESPONSIBILITIES:

Review and interpret insurance eligibility, coverage details, and benefit limitations to determine clearance requirements.
Initiate outbound communication with insurance plans and third‑party payers to obtain benefit details, resolve coverage questions, and confirm authorization requirements.
Navigate prior authorization processes by gathering required information and ensuring payer criteria are met accurately.
Document benefit findings, authorization outcomes, and clearance decisions thoroughly and consistently within internal systems.
Apply feedback and payer knowledge to continuously improve accuracy, efficiency, and overall clearance quality.

QUALIFICATIONS:

Minimum of 1 year of experience in a healthcare or health insurance setting performing eligibility verification, benefits investigation, prior authorizations, or patient access support.
Direct experience working with insurance plans or payers, including outbound calls to obtain or clarify coverage information.
Working knowledge of pharmacy (PBM) benefits and medical benefits, with the ability to interpret plan details accurately.
Experience documenting insurance and authorization information with a high level of accuracy and attention to detail.
Ability to manage detailed, repetitive work in a structured environment while maintaining consistency and quality.
Strong written and verbal communication skills appropriate for professional interactions with payer representatives.
High School Diploma or equivalent.
Must live and work remotely in one the following states: Alabama, Indiana, South Carolina, or Tennessee.

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

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.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you need a reasonable accommodation to complete the online application process, please email [email protected] for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.

The Cigna Group 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 enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

Apply Now

Refine Your Search

eligibility worker jobs in south carolina

Eligibility Representative - Accredo - Remote

ES Eligibility Specialist / 61012458

ES Eligibility Specialist (CNTY) / 61012802

ES Eligibility Case Manager / 61013345

Eligibility Coordinator I / 60017004

REPOST ES Eligibility Case Manager (CNTY) / 61012955

Eligibility Specialist - PRN, As Needed

REPOST CERCU Eligibility Specialist / 61013661

ES Eligibility Specialist (CNTY) / 61012096 & 61012180

Housekeeper

Front Desk Agent

Eligibility Representative II

ES Eligibility Case Manager (CNTY) / 61013211

Eligibility Coordinator II / 60017888

Internal Only: Eligibility Coordinator II / 60015297

Math Teacher

Riddles Escape Room(Looking for ) stop ny in person anytime, We are open every day!!!

SFP Facilitator

Front Desk Agent

Front Desk Agent

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