Eligibility Senior Representative - Accredo - Hybrid (Hawaii)

Location: Honolulu, Hawaii; candidates must live on Oahu. Hybrid work requires in-person attendance at the 677 Ala Moana Blvd, Suite 404, Honolulu office twice per week.

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

Company

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

What you will do

• Verify medical and pharmacy benefits using internal patient-management tools and payer knowledge.
• Contact benefit providers to gather policy benefits, limitations, authorization requirements, deductibles, copayments, and effective dates.
• Coordinate services and shipments to meet insurance criteria, support reimbursement, and minimize bad-debt risk.
• Resolve drug-coverage issues cross-functionally and identify issues affecting revenue optimization.
• Provide referral status reporting and expert patient-status support to external clients.
• Handle complex patient and client complaints, using independent judgment and escalating issues when appropriate.

Requirements

• High school diploma or GED required; bachelor's degree preferred.
• At least 2 years of relevant work experience.
• Healthcare or professional-office experience with medical insurance knowledge and terminology preferred.
• Advanced problem-solving, collaboration, attention to detail, and decision-making skills.
• Intermediate data-entry skills and working knowledge of Microsoft Office.
• Excellent telephone presentation and communication skills; ability to work with minimal supervision in a dynamic environment.

Culture & Benefits

• Hybrid work with required office attendance twice per week.
• Medical, vision, dental, well-being, and behavioral-health benefits available from the first day of employment.
• 401(k), company-paid life insurance, tuition reimbursement, paid time off, paid holidays, and leaves of absence.
• Home internet must use cable broadband or fiber service with at least 10 Mbps download and 5 Mbps upload speeds when working remotely.