Eligibility Senior Representative - Accredo - Hybrid (Hawaii)

Location: Honolulu, Hawaii; candidates must live on the island of Oahu. This is a hybrid role requiring in-person work at the Honolulu office two times per week.

Salary: $19–$29 per hour, depending on experience and geographic location, plus eligibility for an annual bonus plan.

Company

Evernorth Health Services, a division of hirify.global, develops pharmacy, care, and benefit solutions designed to improve access to healthcare and patient outcomes.

What you will do

• Verify medical and pharmacy benefits using internal patient management tools and payer process knowledge.
• Contact benefit providers to gather policy benefits, limitations, deductibles, copayments, effective dates, and authorization requirements.
• Coordinate coverage and reimbursement requirements so specialty-patient services and shipments are processed correctly.
• Resolve drug coverage issues and complex client or patient complaints, escalating issues when appropriate.
• Act as a liaison between internal teams, payers, physicians, pharma partners, patients, and external clients.
• Provide accurate referral status reporting and identify risks that may affect revenue or the patient experience.

Requirements

• High school diploma or GED required; a bachelor's degree is preferred.
• At least 2 years of relevant work experience.
• Healthcare or professional office experience and knowledge of medical insurance terminology preferred.
• Advanced problem-solving skills, attention to detail, independent judgment, and the ability to collaborate across departments.
• Intermediate data-entry skills and working knowledge of Microsoft Office.
• Must live on Oahu and be able to work in person at the Honolulu office twice per week.

Culture & Benefits

• Full-time employment with medical, vision, dental, well-being, and behavioral health benefits starting on the first day.
• 401(k), company-paid life insurance, tuition reimbursement, paid holidays, and leaves of absence.
• At least 18 days of paid time off per year.
• Home internet, when working remotely, must use cable broadband or fiber with at least 10 Mbps download and 5 Mbps upload speeds.
• Tobacco-free workplace policy.